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Cellulitis - acute - Management
How should I treat acute cellulitis?
- People with mild or moderate cellulitis with no systemic illness or uncontrolled comorbidities can usually be managed in primary care. Before treatment, draw around the extent of the infection with a permanent marker pen for future comparison (to track spread of the infection).
- Prescribe a high-dose oral antibiotic for 7 days:
- Flucloxacillin (500 mg four times a day) for most people.
- Erythromycin (500 mg four times a day) for people with penicillin allergy, or clarithromycin (500 mg twice a day) if erythromycin is likely to be poorly tolerated.
- For adults with mild facial cellulitis that does not require admission, prescribe:
- Co-amoxiclav (500/125 mg three times a day) for 7 days.
- Consider adding on a second antibiotic if the cellulitis has arisen from a wound contaminated with water:
- Doxycycline (100 mg once a day) for saltwater contamination.
- Ciprofloxacin (750 mg twice a day) for freshwater contamination.
- Seek expert advice if these are contraindicated (e.g. in pregnant women and children).
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