Limb Cellulitis - Out-Patient Treatment

Micro Organisms

If there is a history of river or sea water exposure, treatment choices should be discussed with a microbiologist.

Duration

5-7 days                                          

First Line

Important: Therapy

Flucloxacillin PO dosed as per BNF for children

          

Penicillin allergy

Important: Therapy

Clarithromycin PO dosed as per BNF for children

Clarithromycin should not be prescribed concurrently with ciclosporin, sirolimus and tacrolimus.

Important: Notes

Cellulitis presents as an area of skin which is acutely red, hot, tender, and swollen; it is not uncommon for blisters or bullae to develop. The leg is the most common site and presentation is almost exclusively unilateral. Minor breaks in the skin can act as portal of entry.

If the patient is not febrile and has no underlying chronic diseases or immunocompromise, cellulitis can be managed as an out-patient or in primary care.

Refer any patient in primary care with the following for IV treatment:

  • comorbidities that may affect wound healing, e.g. diabetes;
  • frail patient
  • any patient that appears systemically unwell.

Take a swab for bacterial culture and sensitivity from any possible portal of entry or areas of broken down skin. Review any culture results and ensure that an appropriate antibiotic has been prescribed.

General advice:  Draw around the perimeter of the affected area with a permanent marker pen for future comparisonAdvise rest and elevation of the affected limb.