Simple Cellulitis - Tx

Notes

Manage predisposing factors: elevate the limb, treat edema, treat tinea pedis, arrange wound care

Often takes 48-72h+ before improvements in erythema/edema

5-10 days depending on response

ORAL: Cephalexin 500-1000 mg PO QID

OR

IV: Cefazolin 2g IV q8h

IV route for patients with systemic signs of infection

Gram negative coverage not necessary unless specific risk factors

Gram negative risk factors

Injury occurring in water (Aeromonas - fresh, Vibrio spp. - salt)

Penetrating injury with foreign body (i.e. nail through shoe)

Diabetic foot infection

Immunocompromise

ALSO CONSIDER

Penicillin monotherapy may be used (oral or IV depending on severity) if the findings are highly suggestive of erysipelas

ORAL: Clindamycin 300-600 mg PO QID

OR

IV: Vancomycin 25-30mg/kg IV load (max 2g) followed by 15mg/kg IV q12h maintenance for a target trough of 15-20µg/mL