-Definition: Cellulitis with intact skin and no evidence of purulent drainage.
-The most common cause is strep or staph. Usually caused by beta-hemolytic streptococci (e.g. group A, B, C, G streptococci) and MSSA.
Tx: Parenteral (Mod to Severe):
–Cefazolin 1g IV q8h or
–Ampicillin/Sulbactam 3g IV q6h.
–PCN allergy: Clindamycin 600mg IV Q8H [At DRMC use vancomycin because Clindamycin has high resistance].
Duration: 5-7 days
– “Always elevate the affected extremity. Treatment failure is more commonly due to failure to elevate than a failure of antibiotics. Improvement of erythema can take days, especially in patients with lymphedema, because dead bacteria in the skin continue to induce inflammation.” Johns Hopkins
If patient has risk factors for MRSA, add Vancomycin
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Tx: Oral (mild):
For Moderate
References
Click to access Antibiotic_guidelines.pdf
http://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540106/all/Cellulitis