Class I: patient afebrile and healthy other than cellulitis, use oral flucloxacillin alone.
Class II febrile & ill, or comorbidity, admit for intravenous treatment
Class III toxic appearance: admit. If river or sea water exposure, discuss with specialist.
MRSA patients – discuss with microbiology
Erysipelas: Often facial and unilateral. Use flucloxacillin for non-facial erysipelas.
Recurrent cellulitis - (i.e. 2 episodes within 12 months at same site) - consider prophylaxis with penoxymethylpenicillin 250mg BD (or 500mg BD if BMI >32).
If on statins: doxycycline
200mg stat then 100mg OD
For 7 days. If slow response continue for a further 7 days
If unresolving: clindamycin
All for 7 days. If slow response continue for a further 7 days