Cellulitis/Wound Infections
Cellulitis
CKS
Drug details
Minor furunculosis, folliculitis and small abscesses WITHOUT cellulitis
NO antibiotics, perform incision and drainage if necessary
Wound infections with minor/moderate cellulitis including facial cellulitis
Minor infection
Oral flucloxacillin 500mg 4 times daily
7-14 days depending on severity of illness
Wound infections with minor/moderate cellulitis including facial cellulitis
Moderate infection
Oral flucloxacillin 1g 4 times daily
7-14 days depending on severity of illness
Wound infections with minor/moderate cellulitis including facial cellulitis
Penicillin allergy or if MRSA suspected (unlicensed indication)
Oral doxycycline 100mg twice daily
7-14 days depending on severity of illness
Wound infections with minor/moderate cellulitis including facial cellulitis
If dirty/ penetrating wound
ADD Oral metronidazole 400mg 3 times daily
7-14 days depending on severity of illness.
If the infection is responding slowly at 7 days, continue for a further 7 days.
If dirty/ penetrating wound ensure surgical washout and assess tetanus immunisation status
Seek advice early if peri-orbital cellulitis suspected.
Major cellulitis or wound infection with gross contamination or in IV drug user
IV flucloxacillin 1 to 2g 4 times daily
Up to 14 days - rationalise to oral route when responding
Major cellulitis or wound infection with gross contamination or in IV drug user
If penicillin allergy or if MRSA suspected
IV vancomycin - refer to NHS Highland vancomycin dosing guidelines
7-14 days depending on severity of illness.
Major cellulitis or wound infection with gross contamination or in IV drug user
If dirty/ penetrating wound
ADD IV gentamicin - refer to NHS Highland gentamicin dosing guidelines
AND IV metronidazole 500mg 3 times daily
7-14 days depending on severity of illness.
Would infections associated with fresh or salt water contamination
Seek advice from Microbiology
Orbital cellulitis
IV ceftriaxone 2g once daily
7 days. Seek advice and refer to Ophthalmologist
Post caesarean section wound infection. Infection often polymicrobial
Co-amoxiclav 625mg 3 times daily
7 days
Post caesarean section wound infection
If penicillin allergy:
Seek advice from Microbiology