Guidelines
Cellulitis - Non-purulent

Cellulitis - Non-purulent

Notes

  • Consider alternative etiologies such as venous stasis or dependent rubor

  • Erythema associated with cellulitis should NOT resolve with elevation of the limb as opposed to chronic venous stasis

  • Resistance is increasing among previously susceptible organisms (Grp A & B Strep, MSSA & MRSA, anaerobes)

  • Very high risk for C. difficile infection

  • Only appropriate as synergistic agent in Grp A Strep necrotizing fascititis and toxic shock syndrome

Microbiology

Beta haemolytic Streptococci (i.e., Group A & B) are the predominant pathogens

Additional Information

Guideline originally sourced from Saskatchewan Health Authority - Saskatoon Area and adapted by Joseph Brant Hospital

  • Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America [published correction appears in Clin Infect Dis. 2015 May 1;60(9):1448. Dosage error in article text]. Clin Infect Dis. 2014;59(2):e10-e52.

  • Sinai Health System & UHN Antimicrobial Stewardship Program Management of Uncomplicated Skin and Skin Structure Infections: Non-Purulent Treatment Guidelines. (No Date). Accessed June 2020 from: www.antimicrobialstewardship.com/nonpurulentssi

  • The Johns Hopkins University (2020) John Hopkins ABX Guide (1.27) [Mobile App] Retrieved from: www.hopkinsguides.com

  • Antimicrobial Therapy Inc (2020) The Sanford Guide (4.2) [Mobile App] Retrieved from: www.sanfordguide.com/

Approved: June 2020

Revised: May 2022 (added cefadroxil for outpatients)