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Cellulitis

Skin (Cellulitis, erysipelas)  Possible therapeutic alternatives
Cellulitis (extremities): No risk factors. Mild cases .

Treatment duration: 
7 - 10 days

Common pathogens
Early / Mild:

Penicillin VK 500mg orally every 6 hours OR
Cephalexin 500mg orally every 6 hours OR
Bactrim DS orally twice daily OR
Cefadroxil 500mg-1g orally every 12 hours OR Cefuroxime 250-500mg orally every 12 hours

Moderate / Severe / Sudden Onset:

Vancomycin 1 gram  ivpb q12h (patient-specific dosing required)  OR
Daptomycin 4 mg/kg IV q 24h OR
Linezolid 600 mg orally or IV q 12h

Erysipelas (sharply demarcated borders)

 

Treatment duration: 
7 - 10 days

Common pathogens
Early / Mild:

Dicloxacillin 500mg orally four times daily OR
Clindamycin 300mg orally four times daily or if severe 600mg IV every 6 hours OR
Cephalexin (Keflex ®) 250-500mg orally every 6 hours OR
Azithromycin
500mg x 1, then 250mg once daily
OR
Augmentin 875/125 mg orally twice daily or  500/125mg three times daily

Hospitalized:

Penicillin G 2-4 million units IV q4-6h OR
Cefotaxime 1-2 grams IV every 8 hours OR
Clindamycin  600mg IV every 6 or 8 hours or 300mg orally four times daily  OR
Cefazolin 1 gram IVPB q8h

Cellulitis: (Risk factors), Diabetes mellitus, Immunosuppressed, ulcerated lesions. Common pathogens

Early/mild:

Penicillin VK 500mg orally every 6 hours OR
Cephalexin 500mg orally every 6 hours
PLUS
Bactrim DS orally twice daily

Hospitalized:
Ampicillin-sulbactam 1.5 - 3 grams  ivpb every 6 hours 

Severe / Hospitalized:

Vancomycin 1 gram  ivpb q12h (patient-specific dosing required)  OR
Daptomycin 4 mg/kg IV q 24h OR
Linezolid 600 mg orally or IV q 12h OR
Ceftaroline 600mg IV q12h.

PLUS - May consider
:
Ertapenem 1 gm IV q24h OR
Doripenem 500 mg IV q8h OR
Meropenem 1 gm IV q8h

Images

Cellulitis

cellulitis

Erysipelas

erys
Cellulitis