Template:Cellulitis antibiotics

Tailor antibiotics by regional antibiogram

Outpatient

Coverage primarily for Strep

MRSA coverage only necessary if cellulitis associated with: purulence, penetrating trauma, known MRSA colonization, IV drug use, or SIRS

• 5 day treatment duration, unless symptoms do not improve within that timeframe
  • Cephalexin 500mg PO q6hrs OR
    • Add TMP/SMX 1DS PO BID if MRSA is suspected
    • Most cases of non-purulent cellulitis are thought caused by Strep. In these cases, the addition of TMP/SMX has been demonstrated to offer no clinical benefit over cephalexin alone.
  • Clindamycin 450mg PO TID
  • Tetracyclines (like Doxycycline) should be avoided in non-purulent cellulitis, due to high rates of Strep resistance

Inpatient

• Vancomycin 20mg/kg IV q12hrs OR
• Clindamycin 600mg IV q8hrs OR
• Linezolid 600mg IV q12hrs OR
• Daptomycin 4mg/kg IV once daily

Saltwater related cellulitis

coverage extended for Vibrio vulnificus

• Doxycycline 100mg PO/IV q12hrs daily + Cefepime 1g IV q12hrs x 10 days
• Ciprofloxacin 400mg IV q12hrs x 10 days
• Ciprofloxacin 750mg PO q12hrs x 10 days

Freshwater related cellulitis

coverage extended for Aeromonas sp

• Ciprofloxacin 400mg IV q12hrs x 10 days
• Ciprofloxacin 500mg PO q12hrs x 10 days
• TMP/SMX 2 DS tablets (5mg/kg) PO q12hrs x 10 days
• Ceftriaxone 1g (50mg/kg) IV q24hrs