Cellulitis

Class I: patient afebrile and healthy other than cellulitis, use oral flucloxacillin alone.

Class II febrile & ill, or comorbidity, admit for intravenous treatment

Class III toxic appearance: admit. If river or sea water exposure, discuss with specialist.

MRSA patients – discuss with microbiology

Erysipelas: Often facial and unilateral. Use flucloxacillin for non-facial erysipelas.

Recurrent cellulitis - (i.e. 2 episodes within 12 months at same site) - consider prophylaxis with penoxymethylpenicillin 250mg BD (or 500mg BD if BMI >32).

 

Flucloxacillin

500mg QDS

For 7 days. If slow response continue for a further 7 days

If penicillin allergic: clarithromycin

500mg BD

For 7 days. If slow response continue for a further 7 days

If on statins: doxycycline

200mg stat then 100mg OD

For 7 days. If slow response continue for a further 7 days

If unresolving: clindamycin

300–450mg QDS

All for 7 days. If slow response continue for a further 7 days

If facial: co-amoxiclav

500/125mg TDS 

All for 7 days. If slow response continue for a further 7 days