What is the treatment for cellulitis?
Antibiotic Treatment
Mild to Moderate Cellulitis
- Flucloxacillin 500mg-1g PO qds (orally, four times a day) for 5-7 days is the first-line treatment
- Consider adding benzylpenicillin 1.2g IV (intravenously) tds (three times a day) if severe or worsening symptoms.
Severe Cellulitis or Systemic Involvement
- Admit the patient to hospital for IV antibiotics.
- Use a broad-spectrum antibiotic such as:
- Piperacillin-tazobactam 4.5g IV tds
- Ceftriaxone 2g IV od (once daily)
- Consider adding clindamycin 600mg IV tds if MRSA (methicillin-resistant Staphylococcus aureus) is suspected.
Penicillin Allergy
Use a non-penicillin antibiotic such as:
- Erythromycin 500mg PO qds
- Clarithromycin 500mg PO bd (twice daily)
Additional Management
- Pain Management: Use analgesics such as paracetamol or ibuprofen to manage pain and discomfort.
- Elevation and Rest: Elevate the affected limb and encourage rest to reduce swelling and promote healing.
- Wound Care: Clean and dress any open wounds or ulcers to promote healing and prevent further infection.
- Monitoring: Monitor the patient’s condition closely, including temperature, blood pressure, and wound progression.
Referral and Admission
- Admit to Hospital: Admit patients with severe cellulitis, systemic involvement, or those who are immunocompromised.
- Refer to Specialist: Refer patients with complex or recurrent cellulitis, or those with underlying conditions such as diabetes or vascular disease.
