Cellulitis - Severe | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Acute Hospital Guidance
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Skin and Skin Structure
Cellulitis - Severe

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

First Line

Important: Therapy

Flucloxacillin 2g IV 6 hourly +/- Gentamicin IV (as per online calculator)

Consider adding:

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

Notes:

Penicillin Allergy

Important: Therapy

Vancomycin IV (as per online calculator) +/- Gentamicin (as per online calculator)

Consider adding

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

Notes:

Important: 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)