Skin & soft tissue (Antimicrobial)

For skin and soft tissue infections requiring intravenous therapy, assess suitability or out-patient IV antibiotic therapy using the SSTI pathway in the first instance. 

For current in-patients consider referral to the Out-patient Parenteral Antibiotic Therapy Service (OPAT) for early supported discharge. 

• Refer to the OPAT website for the SSTI pathway and referral form. (NHS Highland intranet access required).

As resistance is increasing reserve topical antibiotics for very localised lesions.  For minor infections and impetigo only and where Emulsiderm^® will not suffice, topical sodium fusidate 2% ointment can be used for a maximum of 10 days treatment.  For extensive, severe or bullous impetigo, use oral antibiotics.

For paediatric patients, please refer to the current edition of BNF for Children for drug doses.

For zoonotic infections (eg associated with animals or fish), seek advice from Microbiology or Infectious Disease Physician as the causative pathogens may differ.

For the management of cellulitis in a lymphoedema patient, refer to the Lymphoedema section in Therapeutic Guidelines.

Gentamicin therapy must be reviewed at 48 to 72 hours and continued on specialist advice only.

BITE WOUNDS SHOULD NOT BE SUTURED