Cellulitis

Question 1

What criteria do we use to guide management of patients with cellulitis?

Answer 1

Eron criteria:

• I = no systemic involvement + no uncontrolled co-morbidity
• II = systemically unwell OR systemically well with comorbidity that might complicate/delay resolution
• III = significant systemic upset e.g. acute confusion/tachy, hypo OR unstable comorbidities
• IV = sepsis syndrome or necrotising fasciitis

Comorbidities include:
- Peripheral arterial disease, chronic venous insufficiency, morbid obesity)

Question 2

Under what circumstances do we admit for IV Abx in cellulitis?

Answer 2

Eron class III or IV
Severe or rapidly deteriorating cellulitis
Very young (<1) or frail
Immunocompromised
Significant lymphoedema
Facial cellulitis or periorbital cellulitis

Question 3

What antibiotics do we give in cellulitis?

Answer 3

Flucloxacillin as first line

Doxycycline, clarithromycin or erythromycin if penicillin allergic (with erythro being used in pregnancy)

Severe:
- Co-amox, cefuroxime; clindamycin or ceftriaxone