Sandbox/Alejandro
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Medical Therapy
- For patients with purulent cellulitis, cultures are recommended and empirical therapy for Community Associated-MRSA (CA-MRSA) should be started.
- For patients with non-purulent cellulitis, empirical therapy for β-hemolytic streptococci should be started.
- The duration of the therapy should be individualized for the clinical response of each patient; 5-10 days is usually recommended.
- The treatment of cellulitis in neonates usually requires hospitalization and parenteral therapy. Oral therapy is given for completion of the treatment when the pathogen is unknown.
- Optimal dose should be based on determination of serum concentrations.
- Patients with renal insufficiency may require dose adjustment in case of cephalosporins.
- Clindamycin is an alternate therapy for patients at risk of severe hypersensitivity reaction to penicillins and cephalosporins.
- Doxycycline is NOT recommended for children <8 years of age.
- Studies have shown an increase in treatment failure with TMP-SMX compared to other agents for cellulitis in children, reflecting TMP-SMX less action against Group A streptococcus.[1]
Therapy based on Anatomical LocationAdapted from
▸ Click on the following categories to expand treatment regimens.
Location ▸ Buccal ▸ Periorbital ▸ Orbital ▸ Perianal ▸ Facial
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Special ConsiderationsAdapted from
For the following conditions, an additional antibiotic therapy should be added to the usual regimen in order to cover specific pathogens associated to those circumstances.
▸ Click on the following categories to expand treatment regimens.
Special Considerations ▸ Diabetic Foot Ulcer ▸ Neutropenic Patients ▸ Sal Water Wound Exposure ▸ Fresh Water Wound Exposure ▸ Butcher, Fisherman, Veterinarian
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References
- ↑ Elliott DJ, Zaoutis TE, Troxel AB, Loh A, Keren R (2009). "Empiric antimicrobial therapy for pediatric skin and soft-tissue infections in the era of methicillin-resistant Staphylococcus aureus". Pediatrics. 123 (6): e959–66. doi:10.1542/peds.2008-2428. PMID 19470525.