Cellulitis

Duration

Total IV/PO 7 – 10 days

Class 1 SSTI but no signs or symptoms of toxicity or co-morbidities.

Flucloxacillin 1g PO four times daily

or

if penicillin allergy  Clarithromycin PO 500mg 12 hourly

Class 2 Either systemically unwell or systemically well but with co-morbidiity (eg diabetes ) that may complicate or delay resolution.

Flucloxacillin 1-2g  IV 6 hourly

Or

If penicillin allergy Vancomycin IV + / -Gentmicin IV

Class 3 Signs of systemic upset (fever with tachycardia , tachypnoea and /or hypotension)

Flucloxacillin 1.2g IV 6 hourly +/- clindamycin 900mg IV 8 hourly

If penicillin allergy Vnacomycin IV +/- Gentamicin IV +/- Clindamycin 900mg IV 8 hourly

Typical duration = 10 days

Class 4 Treat as Necrotising facittis and seek advice from microbiology. Sepsis syndrome of life threatening infection

IV Flicloxacillin 1g 6 Hourly

IV Benzypenicillin 1.2g 6 Hourly

IV Clindamycin 900mg 8 Hourly

IV Gentamicin

Iv Metronidazole 500mg 8 Hourly

In case of allergy discuss with Duty Consultant Microbiologist

Lymph oedema

Co-amoxiclav  1.2g IV 8 hourly or PO 625mg 8 hourly

Notes

See full guidance to assess severity