Cellulitis
Antimicrobial prescribing: NHS Forth Valley
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).
Drug details
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
orDoxycycline
200mg STAT then 100mg OD
5-7 days
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