Cellulitis - Severe

First Line

Therapy

Flucloxacillin 2g IV 6 hourly +/- Gentamicin IV as per protocol

 

Consider adding:

Clindamycin 450mg 6 hourly PO OR 600mg 6 hourly IV

Penicillin Allergy

Therapy

Vancomycin IV +/- Gentamicin IV as per protocol

 

Consider adding

Clindamycin 450 mg PO 6 hourly OR 600mg IV 6 hourly

Notes

Mark boundary of cellulitis and review regularly.

Seek surgical review ASAP as clinically indicated, especially if severe pain or rapid spread / clinical deterioration despite antibiotics.

Send swabs for culture. Even if no break in skin a firm swab of most cellulitic area may yield pathogen to guide management.

Treatment duration: 7 days (may be longer depending on severity of systemic infection and clinical response)