Cellulitis

Despite increases in community-acquired MRSA infections in recent years, the majority of uncomplicated cases of cellulitis are caused by Group A streptococci and Methicillin Susceptible strains of S. aureus. Any time it is feasible a specimen should be obtained for specific laboratory diagnosis.

For a thorough treatment of community-acquired MRSA infection diagnosis and therapy see Community-acquired MRSA.

Usual Pathogens
Group A Streptococci (associated with IV drug use, human bites)
Methicillin sensitive S. aureus (MSSA)

Recommended Empiric Therapy (7-10 days)

Oral Options:

Cephalexin 500 mg PO QID

Severe pen-allergy or cephalosporin allergy (anaphylaxis or angioedema)

Clindamycin 600 mg PO TID
(less than 50 kg and gastro upset try 300 mg PO QID)

Parenteral Options:

Cefazolin 1 g IV q8h
OR Cefazolin 2 g IV daily + probenecid PO 1 g daily
– 1 dose of probenecid 30 min. prior cefazolin.
– outpatient once-daily management and then reassess in 72 hours for efficacy.

Severe pen-allergy or cephalosporin allergy (anaphylaxis or angioedema)

Clindamycin 600 mg IV q8h

Category: Skin and Soft Tissue Infections

Other Therapy Guidelines

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