Spectrum: Local Antimicrobial Stewardship, for Island Health

Acute, Uncomplicated Cellulitis - Tx

Suggested Regimen

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

  •  Fresh water - Aeromonas

  •  Salt water - Vibrio spp.

Penetrating injury with foreign body

  •  e.g. 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

Penicillin Anaphylaxis

ORAL: Clindamycin 300-600 mg PO QID

OR

Vancomycin (Low Target Trough Dose)

Notes

Manage predisposing factors:

  •  Elevate the limb

  •  Treat edema

  •  Treat tinea pedis

  •  Arrange wound care

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

Duration of Therapy

5-10 days depending on response.