It is very interesting that how fast we are changing our practice lately. Still remember when we started to give double dose of TMP/SMZ plus cephalexin for cellulitis, and then we changed it to 1 dose of TMP/SMZ + cephalexin and then we doubted if cephalexin is necessary or not. JAMA published a randomized study showing “Effect of Cephalexin Plus Trimethoprim-Sulfamethoxazole vs Cephalexin Alone on Clinical Cure of Uncomplicated Cellulitis”. 496 patients received cephalexin plus trimethoprim-sulfamethoxazole vs cephalexin plus placebo in uncomplicated cellulitis. They found no difference in higher rates of clinical resolution of cellulitis, only slightly different in treating diabetic and adverse effect!