Cellulitis is a term used to describe infection of the dermal and subcutaneous skin layers. The condition is diagnosed based on symptoms and clinical examination to identify the causative bacteria. A suitable antibiotic is then prescribed.
The overall steps taken in the treatment of cellulitis include:
- Medications to control fever, pain and symptoms – Usually paracetamol or ibuprofen is used to control the fever and pain associated with cellulitis. Patients are advised to drink plenty of water and if the leg is infected, it needs to be kept elevated to reduce the swelling and ease pain.
- Antibiotics – A swab may be taken from the infected area and sent for laboratory testing to identify which antibiotic may be effective. In patients who are well enough to be treated at home, a seven day course of antibiotics is usually prescribed.
Common examples of the antibiotics used include penicillin, flucloxacillin, erythromycin, doxycycline sulfamethoxazole/trimethoprim and ciprofloxacin. Some of these may be used in combination.
- Hospitalization – In severe cases, the patient may need to be admitted to hospital. In the hospital, antibiotics are administered directly into the vein along with intravenous fluids. Usually, a three to four day course is given before the patient is switched to an oral form of antibiotic.
Intravenous antibiotics include cefotaxime, ceftriazone or cefazolin. Antibiotics that may be used in special cases such as diabetic cellulitis include combined amoxicillin and clavulanic acid, clindamycin and vancomycin. Vancomycin is effective in patients who have methicillin resistant staphylococcus aureus (MRSA) infection.
- Recurrent cellulitis patients need to avoid trauma or skin injuries to the legs and feet. This is especially true for patients with diabetic neuropathy who may have lost feeling in the peripheral limbs and become more prone to injury.
Reviewed by Sally Robertson, BSc