Clinical features

  • Erythema
  • Swelling
  • Tenderness
  • Often superficial blistering
  • May arise from skin break (abrasion, athlete’s foot)

Investigations

  • Blood culture (if systemically unwell or if IV antibiotics are started)
  • Swab of discharge from superficial lesions for culture

Infection Control

Basic universal precautions

Treatment

There is no additional benefit from prescribing benzylpenicillin in addition to flucloxacillin

Consider oral treatment if there are no features of systemic upset or localised deep-seated infection

IV

FLUCLOXACILLIN IV 2g 6 hourly

 If true penicillin allergy or MRSA known / suspected:

VANCOMYCIN IV Dose as per calculator

Oral

FLUCLOXACILLIN PO 1g 6 hourly

If true penicillin allergy or MRSA known / suspected:

COTRIMOXAZOLE PO 960mg 12 hourly

 If true penicillin allergy or MRSA known / suspected, & eGFR < 35:

DOXYCYCLINE PO 100mg 12 hourlyDuration: 7-10 days