Cellulitis
Antimicrobial prescribing: NHS Fife
Clinical features
- Erythema
- Swelling
- Tenderness
- Often superficial blistering
- May arise from skin break (abrasion, athlete’s foot)
Investigations
- Blood culture (if systemically unwell or if IV antibiotics are started)
- Swab of discharge from superficial lesions for culture
Infection Control
Basic universal precautions
Treatment
There is no additional benefit from prescribing benzylpenicillin in addition to flucloxacillin
Consider oral treatment if there are no features of systemic upset or localised deep-seated infection
IV
FLUCLOXACILLIN IV 2g 6 hourly
If true penicillin allergy or MRSA known / suspected:
VANCOMYCIN IV Dose as per calculator
Oral
FLUCLOXACILLIN PO 1g 6 hourly
If true penicillin allergy or MRSA known / suspected:
COTRIMOXAZOLE PO 960mg 12 hourly
If true penicillin allergy or MRSA known / suspected, & eGFR < 35:
DOXYCYCLINE PO 100mg 12 hourlyDuration: 7-10 days