Cellulitis

NHSL Antimicrobial Guidelines
NHS Lanarkshire

Cellulitis

CKS: Cellulitis - acute

Class I: patient afebrile and healthy other than cellulitis, use oral flucloxacillin alone.1,2,5C

Class II: febrile & ill or comorbidity, admit for intravenous treatment or contact OPAT (Outpatient  Parenteral Antimicrobial Therapy) via Monklands switchboard.

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

Consider alternative diagnosis if unresolving.

For patients with indwelling arthroplasty DO NOT treat with empirical antibiotics. Refer immediately to surgical team for acute assessment wherever possible. (For severe infection out of hours refer to A&E). Empiric antibiotics prevent pathogen source being identified via culture sensitivity testing and can significantly effect onward management.

Drug details

Drug

Flucloxacillin

Duration

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

Drug

If Penicillin allergic:
Clarithromycin

Duration

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

Drug

If on statins:
Doxycycline

Dosage

200mg stat then 100mg OD

Duration

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

Drug

If facial:
Co-amoxiclav

Duration

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

Editorial Information

Last reviewed: 22/03/2021

Next review date: 22/03/2024

Author(s): NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick.

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.