Adjunctive clindamycin for cellulitis: clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis

Objective: To compare flucloxacillin with clindamycin to flucloxacillin alone for the treatment of limb cellulitis. Design: Parallel, double-blinded, randomised controlled trial. Setting: Emergency department attendances and general practice referrals within 20 hospitals in England. Interventions: Flucloxacillin, at a minimum of 500 mg 4 times per day for 5 days, with clindamycin 300 mg 4 times per day for 2 days given orally versus flucloxacillin given alone. Main outcome measures: The primary outcome was improvement at day 5. This was defined as being afebrile with either a reduction in affected skin surface temperature or a reduction in the circumference of the affected area. Secondary outcomes included resolution of systemic features, resolution of inflammatory markers, recovery of renal function, reduction in the affected area, decrease in pain, return to work or normal activities and the absence of increased side effects. Results: 410 patients were included in the trial. No signif...