Erysipelas and cellulitis

In this area
Erysipelas and cellulitis

Can antibiotics prevent erysipelas from coming back?

Elderly man taking tablets on a sofa

Taking a low dose of penicillin can prevent erysipelas from returning in people who have already had this skin . When used for this purpose, the penicillin is taken every day for up to twelve months. This preventive treatment is well tolerated.

Erysipelas is a skin that can develop if bacteria get into injured skin, cracked skin or a sore and infect the outer layers of skin. It can usually be treated successfully with .

Some people get erysipelas again and again. This is thought to happen in about 1 out of 3 people who have had it. Doctors will try to find the underlying cause of the new and treat it. Possible causes include other skin conditions like athlete's foot or impetigo, as well as poor blood circulation – for example, due to venous insufficiency.

If treating the cause doesn't stop erysipelas from returning, preventive treatment with can help. This involves taking (like penicillin tablets, for instance) twice a day over a number of months. Alternatively, the can be injected into a muscle every 14 days.

Do antibiotics prevent erysipelas?

Two reliable studies looked at how well helped to prevent new erysipelas infections. All of the people in the studies had already had erysipelas at least once. They were given either a low dose of penicillin or a placebo (dummy drug).

Within three years of having this preventive treatment, a new bacterial skin occurred in

  • 43 out of 100 people who took a placebo.
  • 32 out of 100 people who took penicillin.

Is penicillin well tolerated?

Side effects like nausea, diarrhea, rashes and fungal infections are often associated with . But the two studies showed that these side effects weren't more common in the low-dose penicillin group than they were in the placebo group.

Some people can't take penicillin at all because they're allergic to it. This type of is very rare, though.

Important:

It is important to use antibiotics correctly – to ensure that they work and to prevent from becoming resistant to them. Ask your doctor or pharmacist to explain exactly how to take them.

Dalal A, Eskin-Schwartz M, Mimouni D et al. Interventions for the prevention of recurrent erysipelas and cellulitis. Cochrane Database Syst Rev 2017; (6): CD009758.

Oh CC, Ko HC, Lee HY et al. Antibiotic prophylaxis for preventing recurrent cellulitis: a systematic review and meta-analysis. J Infect 2014; 69(1): 26-34.

Thomas K, Crook A, Foster K et al. Prophylactic antibiotics for the prevention of cellulitis (erysipelas) of the leg: results of the UK Dermatology Clinical Trials Network's PATCH II trial. Br J Dermatol 2012; 166(1): 169-178.

Thomas KS, Crook AM, Nunn AJ et al. Penicillin to prevent recurrent leg cellulitis. N Engl J Med 2013; 368(18): 1695-1703.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas - either via our form or by gi-kontakt@iqwig.de. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?”

Print page

Can antibiotics prevent erysipelas from coming back?

Über diese Seite

Created on July 8, 2025

Next planned update: 2028

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

Stay informed

Subscribe to our newsletter or newsfeed. You can find our growing collection of films on YouTube.

Print page