• Cellulitis SSOU Guideline


     Acute onset of superfi cial skin infection in an otherwise well, ambulant patient. 

    Note that abscesses need incision and drainage as well as antibiotic treatment. 

    Admission Criteria

    • Clinical diagnosis of cellulitis
    • Awaiting HITH transfer in < 24hrs
    • Failed min 24 hrs oral therapy (relative)
    • DVT unlikely clinically


    Exclusion Criteria

    • Major co-morbidities ie diabetes, peripheral vasc dis / DVT
    • Bilateral cellulitis (liposclerosis more likely)
    • Severe cellulitis involving orbital area, facial, perineal region
    • Extensive tissue damage or sloughing
    • Obvious subcutaneous collection requiring surgical drainage
    • Chronic lymphoedema



    • FBE
    • UEC
    • Glucose 
    • Consider ultrasound if in doubt about DVT or collection


    Suggested Medications

    Drug Dose  Frequency  Route 
    Cephalexin (preferred if referring to HITH) 2g12/24IV
    Diclox / Flucloxacillin1-2g6 hourlyoral / IV
    Paracetamol 1g 4-6/24oral 


    Specific Observations

    • Report any increasing redness, pain or swelling
    • Report evidence of systemic infection / sepsis


    Specific Management Issues

    • HITH notification early if HITH is intended discharge destination
    • General Medicine (AMU) registrar if HITH admission required. 
    • Surgical consult if collection suspected that cannot be drained in ED (most skin abscesses can be drained in ED, as the ED reg or consultant first)


    Discharge Criteria

    • Afebrile (T <38 C)
    • Follow – up arranged
    • HITH arranged
    • Independent in ADL


    Hospital Admission Criteria

    • Persisting systemic illness
    • Progressing cellulitis
    • Unclear diagnosis
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