Cellulitis

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).

 

Flucloxacillin

500mg - 1g QDS

Child

1 month to 1 year: 62.5mg to 125mg QDS

2 to 9 years: 125mg to 250mg QDS

10 to 17 years: 250mg to 500 mg QDS

5-7 days

Penicillin allergy: Clarithromycin

500mg BD

Child

1 month to 11 years:

Under 8 kg - 7.5mg/kg BD

8 to 11 kg - 62.5mg BD

12 to 19 kg - 125mg BD

20 to 29 kg - 187.5mg BD

30 to 40 kg - 250mg BD

 

12 to 17 years: 250mg to 500mg BD

5-7 days

or Doxycycline

200mg STAT then 100mg OD

5-7 days

If near eyes or nose: Co-amoxiclav

 

(Refer to peri-orbital/orbital cellulitis protocol as required)

625mg TDS 

 

Child

1 to 11 months: 0.25ml/kg of 125/31 suspension TDS

1 to 5 years: 5ml of 125/31 suspension TDS or 0.25ml/kg of 125/31 suspension TDS

6 to 11 years: 5ml of 250/62 suspension TDS or 0.15ml/kg of 250/62 suspension TDS

12 to 17 years: 250/125mg TDS or 500/125mg TDS

7 days

or if penicillin allergy:

Doxycycline

and 

Metronidazole 

(Refer to peri-orbital/orbital cellulitis protocol as required)

 

100mg BD

 

400mg TDS

7 days