Cellulitis - Severe | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Community Hospital Guidance
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Skin and Soft Tissue Infection
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

Ceftriaxone 2g IV 24 hourly (administered as per local SOP)

Linezolid 600mg PO 12 hourly

(risk of serious drug interactions with linezolid – check BNF or discuss with pharmacy)

Notes:

Important: Notes

Mark boundary of cellulitis and review regularly.

Patients with severe cellulitis can deteriorate rapidly. Consider admission, especially if severe pain, rapid spread of cellulitis or haemodynamically unstable.

It is recommended to send swab(s) for culture where there has been poor clinical response to an empirical antibiotic previously or where antibiotic options are limited e.g. allergy, drug interaction. 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)