Table 2.

Suggested initial oral and IV recommendations for treatment of cellulitis

	No penicillin allergy	Non-severea penicillin allergy	Severea penicillin allergy
Initial PO therapy	Flucloxacillin 500 mg – 1 g qds PO	As for severe pen allergy or cephalexin 500 mg qds PO	Clarithromycin 500 mg bd PO or Doxycycline 100 mg bd PO
Initial IV therapy	Flucloxacillin 1–2 g 6-hourly IV	Ceftriaxone 1–2 g OD	Clindamycin 600 mg – 1.2 g IV qds IV or IV vancomycin

^aSevere penicillin allergy: anaphylaxis, angioedema, stridor, immediate onset urticarial

Note: MRSA colonised: consider adding vancomycin and discuss with local infectious diseases / microbiology team.

Antimicrobial choice in suspected necrotising fasciitis or cellulitis with systemic sepsis syndrome should be discussed urgently with local infectious diseases / microbiology team.

bd = twice daily; PO = oral; IV = intravenous; qds = four times daily