Cellulitis

Micro-organism

Staphylococcus aureus, Streptococcus pyogenes

Duration

Total 7 -14 days

Notes
  • Take appropriate specimens before starting therapy, consult dermatologist and medical microbiologist for patients with severe or recurrent infections.
  • Send blood for culture
  • Consider the necessity for surgical intervention, tetanus prophylaxis and topical cleaning
  • Chronic wounds such as pressure sores and leg ulcers do not require antibiotics unless there is clinical evidence of infection eg cellulitis, discharge or acute pain
  • Longer courses may be required in severe infections
  • If MRSA is likely use IV Vancomycin as 1st line
Mild

Oral Flucloxacillin 1g 6 hourly 

If Strep pyogenes isolated rationalise therapy ie change to or add benzylpenicillin IV or amoxicillin oral

Mild - Penicillin Allergy

Oral Clarithromycin 500mg 12 hourly

 

Moderate to Severe

IV Flucloxacillin 1 - 2g 6 hourly (use 2g if BMI >30)

Switch to

Oral Flucloxacillin 1g 6 hourly 

If Strep pyogenes isolated rationalise therapy ie change to or add benzylpenicillin IV or amoxicillin oral

Moderate to Severe - Penicillin Allergy or MRSA

Vancomycin IV as per guideline

Use preferred calculator on Hospital portals page [intranet access only] or calculator on app for intermittent dosing.

Switch to

Oral Doxycycline 100mg 12 hourly