Cellulitis is characterised by an acute, diffuse,
spreading, oedematous non suppurative inflammation of the dermis and
subcutaneous tissues.1 Cellulitis can cause mild discomfort to
severe complications like sepsis, local gangrene, necrotising fasciitis,
septicaemia which can lead to death.2 Condition of necrotising
fasciitis is very dangerous which has 39% of mortality rate.3
Cellulitis is usually
caused by ?-hemolytic streptococci (BHS) that are susceptible to penicillin and
other narrow-spectrum antibiotics4. However, there are significant
treatment challenges, including overuse of broad-spectrum and intravenous
antibiotics5,6, difficulties regarding when to initiate rescue
therapy and when to stop treatment7, and frequent recurrences8. Toxin effects and profound local
inflammation, not necessarily corresponding to bacterial burden or antibiotic
needs, may contribute to these problems7,9. Also, host factors
affecting the dynamics of treatment response may adversely impact antibiotic
choices and other resource use.
Clavulanic acid, a naturally occurring betalactamase
inhibitor, has been shown to prevent the enzymatic degradation of beta-lactam antibiotics
by a number of bacterial species. Combinations of clavulanic acid and
amoxicillin (ACA) show greater activity in vitro against these bacteria than
does amoxicillin alone 10,11,12. Clinical trials in adults have
shown that ACA is effective against SSI, respiratory and urinary tract
infections caused by ampicillin-susceptible and ampicillin resistant organisms 13,
14,15, 16, 17.
?-Lactamase inhibitors are themselves ?-lactam antibiotics, usually with
minimal or no antibacterial activity. When combined with certain ?-lactam
antibiotics, they augment the potency of these against ?-lactamase-producing
bacteria. Sulbactam is a commercially available ?-lactamase inhibitor.
Ceftriaxone is a type of antibiotic called a cephalosporin. These antibiotics
are related to penicillin. Ceftriaxone is used to treat infections with
bacteria.Ceftriaxone is used in combination with sulbactam for the treatment of
soft tissue infections.The potency of antibiotic drugs increases manifold when
combined with ?-Lactamase inhibitors.
This study will compare the efficacy of
amoxicillin and clavulanic acid versus ceftriaxone and sulbactum in patients
suffering from cellulitis.