Antibiotics for Cellulitis/Erysipelas in Lymphoedema

First-line antibiotics*

Flucloxacillin 1g six hourly

If allergic to penicillin*

Clarithromycin 500mg twelve hourly

Or Erythromycin 500mg 6 hourly in pregnancy

Second-line antibiotics*

Consult Microbiologist

Antibiotics should be given for 14 days.

If recurrence/deterioration occurs soon after completion of a 14-day course, consult Microbiologist.

Longer courses are occasionally needed.

_{*Dosages are for oral treatment unless otherwise stated. Doses suggested are for adults and assume normal renal and hepatic function.}

_{iv = intravenously}

See NHS Borders Antimicrobial Guidelines for Hospitals.

For second line antibiotics, consult Microbiologist.

First-line antibiotics*

Phenoxymethylpenicillin 250mg 12 hourly

or Flucloxacillin 500mg once daily

Depending on previous culture and sensitivity results

If allergic to penicillin*

Clarithromycin 250mg once daily

Or Erythromycin 250mg 12 hourly in pregnancy

_{*Dosages are for oral treatment unless otherwise stated. Doses suggested are for adults and assume normal renal and hepatic function.}

_{iv = intravenously}

5d supply and to seek medical advice

First-line antibiotics*

Flucloxacillin 1g six hourly

If allergic to penicillin*

Clarithromycin 500mg twelve hourly

Or

Erythromycin 500mg 6 hourly in pregnancy

If fails to resolve, or constitutional symptoms develop, convert to iv regimen as for hospital admission

_{*Dosages are for oral treatment unless otherwise stated. Doses suggested are for adults and assume normal renal and hepatic function.}

_{iv = intravenously}

First-line antibiotics*

Co-amoxiclav 625mg eight hourly

If allergic to penicillin* (excluding pregnancy and children)

Doxycycline 100mg twelve hourly + Metronidazole 400mg eight hourly

Second-line antibiotics*

Consult Microbiologist

_{*Dosages are for oral treatment unless otherwise stated. Doses suggested are for adults and assume normal renal and hepatic function.}

_{iv = intravenously}