Template:Cellulitis antibiotics: Difference between revisions

Revision as of 01:09, 20 March 2026

Other languages:

English
español

Tailor antibiotics by regional antibiogram

Outpatient

5 day treatment duration
- Cephalexin 500mg PO q6hrs OR
  - Add DS 1 tab PO BID if MRSA suspected
- Clindamycin 450mg PO TID covers Strep and Staph

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

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

Freshwater related cellulitis

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

@@ Line 2: / Line 2: @@
 <translate>
 <!--T:1-->
-''Tailor antibiotics by regional antibiogram''<ref>Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52</ref>
+''Tailor antibiotics by regional antibiogram''
-====Outpatient==== <!--T:2-->
+====Outpatient====
+<!--T:2-->
+*5 day treatment duration
+**{{AntibioticDose|disease=Cellulitis|drug=Cephalexin|dose=500mg PO q6hrs|context=Outpatient}} '''OR'''
+***Add {{AntibioticDose|disease=Cellulitis|drug=Trimethoprim-Sulfamethoxazole DS|display=TMP/SMX|dose=DS 1 tab PO BID|context=Outpatient, MRSA|link=no}} if MRSA suspected
+**{{AntibioticDose|disease=Cellulitis|drug=Clindamycin|dose=450mg PO TID|context=Outpatient}} covers Strep and Staph
+====Inpatient====
 <!--T:3-->
-''Coverage primarily for [[Special:MyLanguage/Strep|Strep]]''<br />
+*{{AntibioticDose|disease=Cellulitis|drug=Vancomycin|dose=20mg/kg IV q12hrs|context=Inpatient}} '''OR'''
+*{{AntibioticDose|disease=Cellulitis|drug=Clindamycin|dose=600mg IV q8hrs|context=Inpatient}} '''OR'''
+*{{AntibioticDose|disease=Cellulitis|drug=Linezolid|dose=600mg IV q12hrs|context=Inpatient}} '''OR'''
+*{{AntibioticDose|disease=Cellulitis|drug=Daptomycin|dose=4mg/kg IV once daily|context=Inpatient}}
+====Saltwater related cellulitis====
 <!--T:4-->
-''[[Special:MyLanguage/MRSA|MRSA]] coverage only necessary if cellulitis associated with: purulence, penetrating trauma, known MRSA colonization, IV drug use, or SIRS''<ref name="IDSA guidelines">Stevens D, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52</ref>
+*{{AntibioticDose|disease=Cellulitis|drug=Doxycycline|dose=100mg PO/IV q12hrs daily|context=Saltwater}} + [[Cefepime]] 1g IV q12hrs x 10 days
-*5 day treatment duration, unless symptoms do not improve within that timeframe<ref name="IDSA guidelines" />
+*{{AntibioticDose|disease=Cellulitis|drug=Ciprofloxacin|dose=400mg IV q12hrs x 10 days|context=Saltwater}}
-**[[Special:MyLanguage/Cephalexin|Cephalexin]] 500mg PO q6hrs '''OR'''
-***Add [[Special:MyLanguage/TMP/SMX|TMP/SMX]] DS 1 tab PO BID<ref>Cadena J, et al. Dose of trimethoprim-sulfamethoxazole to treat skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus. Antimicrobial agents and chemotherapy 55.12 (2011): 5430-5432.</ref> if [[Special:MyLanguage/MRSA|MRSA]] is suspected
-***Most cases of non-purulent cellulitis are caused by Strep. In these cases, the addition of TMP/SMX has been demonstrated to offer no clinical benefit over cephalexin alone.<ref>Pallin D, et al. Clinical trial: comparative effectiveness of cephalexin plus trimethoprim-sulfamethoxazole versus cephalexin alone for treatment of uncomplicated cellulitis: a randomized controlled trial. Clinical infectious diseases 56.12 (2013): 1754-1762</ref>
-**[[Special:MyLanguage/Clindamycin|Clindamycin]] 450mg PO TID covers both Strep and Staph
-**Tetracyclines (like [[Special:MyLanguage/Doxycycline|Doxycycline]]) should be avoided in non-purulent cellulitis due to high rates of Strep resistance<ref>Traub, W and Leonhard, B. Comparative susceptibility of clinical group A, B, C, F, and G beta-hemolytic streptococcal isolates to 24 antimicrobial drugs. Chemotherapy 43.1 (1997):10-20.</ref>
+====Freshwater related cellulitis====
-====Inpatient==== <!--T:5-->
+<!--T:5-->
+*{{AntibioticDose|disease=Cellulitis|drug=Ciprofloxacin|dose=500mg PO q12hrs x 10 days|context=Freshwater}}
-<!--T:6-->
+*{{AntibioticDose|disease=Cellulitis|drug=Trimethoprim-Sulfamethoxazole DS|display=TMP/SMX|dose=2 DS tablets PO q12hrs x 10 days|context=Freshwater}}
-*[[Special:MyLanguage/Vancomycin|Vancomycin]] 20mg/kg IV q12hrs '''OR'''
+*{{AntibioticDose|disease=Cellulitis|drug=Ceftriaxone|dose=1g (50mg/kg) IV q24hrs|context=Freshwater}}
-*[[Special:MyLanguage/Clindamycin|Clindamycin]] 600mg IV q8hrs '''OR'''
-*[[Special:MyLanguage/Linezolid|Linezolid]] 600mg IV q12hrs '''OR'''
-*[[Special:MyLanguage/Daptomycin|Daptomycin]] 4mg/kg IV once daily
-====Saltwater related cellulitis==== <!--T:7-->
-<!--T:8-->
-''coverage extended for [[Special:MyLanguage/Vibrio vulnificus|Vibrio vulnificus]]''
-*[[Special:MyLanguage/Doxycycline|Doxycycline]] 100mg PO/IV q12hrs daily + [[Special:MyLanguage/Cefepime|Cefepime]] 1g IV q12hrs x 10 days
-*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 400mg IV q12hrs x 10 days
-*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 750mg PO q12hrs x 10 days
-====Freshwater related cellulitis==== <!--T:9-->
-<!--T:10-->
-''coverage extended for [[Special:MyLanguage/Aeromonas sp|Aeromonas sp]]''
-*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 400mg IV q12hrs  x 10 days
-*[[Special:MyLanguage/Ciprofloxacin|Ciprofloxacin]] 500mg PO q12hrs x 10 days
-*[[Special:MyLanguage/TMP/SMX|TMP/SMX]] 2 DS tablets (5mg/kg) PO q12hrs x 10 days
-*[[Special:MyLanguage/Ceftriaxone|Ceftriaxone]] 1g (50mg/kg) IV q24hrs
 </translate>