Cellulitis
The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.
Treatment of cellulitis (no systemic symptoms)
Flucloxacillin
Flucloxacillin 500mg capsules
500mg-1g every 6 hours for 5 days.
If allergic to penicillin.
Doxycycline
Doxycycline 100mg capsules
200mg on day 1, then 100mg daily for 5 days in total.
Skin and soft tissue infections in people who inject drugs (If allergic to penicillin).
Clindamycin
Clindamycin 150mg capsules
450mg 6 hourly for 5-7 days. Alternatively consider clindamycin 600mg three times daily.
Prescribing Notes:
- Flucloxacillin has adequate streptococcal cover; therefore, it is not necessary to prescribe penicillin in addition, for empirical treatment of non-severe cellulitis.
- All wounds have potential for bacterial infection and may become colonised, but swabs should only be taken if there are clinical signs of infection.
- Prescription of antibiotics should not delay appropriate surgical management e.g. drainage or aspiration of an abscess.
- Skin and soft tissue infections in drug users:
- Initial oral treatment is advised with flucloxacillin or oral clindamycin (in penicillin allergy or intolerance). Clindamycin should be stopped and specialist infection advice sought if diarrhoea develops on treatment.
- Please take a wound swab, indicating that the infection is in a person who injects drugs.
History Notes
30/07/2026
Regional formulary chapter launched.
Treatment of orbital cellulitis
Urgent referral to ENT, Ophthalmology and Microbiology.
History Notes
30/07/2026
Regional formulary chapter launched.