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WHAT ARE TREATMENTS FOR CELLULITIS?
* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.
1. For most patients with nonpurulent (non-pus) cellulitis, empiric therapy effective against both group A streptococci and S. aureus is used.
Oral therapy is usually adequate for mild infections
A. Dicloxacillin 250 mg 4 x / day *
B. Cephalexin (Keflex) 250-500 mg 4 x / day *
C. Pen vk 250-500 mg 4 x / day *
D. Clindamycin 300-450 mg 4 x / day *
E. Bactrim (800/160mg) 2 x / day #
3. For patients allergic to penicillin:
A. Clindamycin 300 to 450 mg 3 times a day #
B. Bactrim (800/160mg) 2 x / day #
4. For patient with mild cellulitis from a dog or cat bites: (see Cat Bites, or Dog Bites for specifics)
A. Amoxicillin/clavulanate 875 mg orally every 12 hours. #
B. If penicillin allergic, Clindamycin 300 to 450 mg 3 times a day #
FOR SEVERE CELLULITIS
A. Vancomycin IV plus Piperacillin/taxobactam or imipenem/cilastatin *
CAUTION:
1. Although antibiotic pills can sometimes be used to treat Cellulitis, they might not be effective. Contact your provider if you are not improving within 24-48 hours.
2. All medication, including all oral antibiotics and all medications that come in lotions, ointment, and creams have a risk of side effects.
3. Possible Mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.
4. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
5. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.
Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.
WHAT ARE THE SYMPTOMS OF CELLULITIS?
The symptoms of cellulitis are hot, red, swollen skin, which is painful to touch. Often the skin resembles the surface of an orange. The borders are usually indistinct, except in erysipelas (a type of cellulitis with sharply demarcated margins). Petechiae (small red spots) are also common. Vesicles (small fluid filled sacs) and Bullae (large fluid filled sacs) may also develop and rupture.
WHAT THE CAUSES OF CELLULITIS?
Cellulitis is caused when bacteria, most commonly streptococcus and staphylococcus, enter through a crack or break in the skin.
Cellulitis may also be caused by a more serious staphylococcus infection that are resistant to many antibiotics, called Methicillin Resistant Staphylococcus aureus (MRSA).
HOW IS CELLULITIS DIAGNOSED?
Cellulitis can be diagnosed from taking a careful history and making careful visual inspection. A skin culture (taking a sample of the fluid or pus for the effected area and sending it to a laboratory for further examination) is usually not done. But, if the cellulitis is particularly severe, or not responding to oral antibiotics, both a blood and a skin culture may be obtained to try to identify the exact bacteria causing the cellulitis.