What is the suggested topical corticosteroid (steroid) cream for the treatment of cellulitis?

From the Guidelines

Steroid creams are not recommended for cellulitis treatment. Cellulitis is a bacterial skin infection that requires antibiotics, not steroids. Steroid creams can actually worsen cellulitis by suppressing the immune response and potentially allowing the infection to spread more deeply.

Key Points to Consider

• The standard treatment for cellulitis includes oral antibiotics such as cephalexin (500mg four times daily), dicloxacillin (500mg four times daily), or clindamycin (300-450mg four times daily) for 5-10 days, depending on severity, as recommended by the Infectious Diseases Society of America 1.
• In more severe cases, intravenous antibiotics may be necessary.
• Along with antibiotics, patients should elevate the affected area, rest, and apply warm compresses to improve circulation and reduce swelling.
• If you suspect cellulitis, which typically presents as a red, swollen, painful area of skin that feels warm to the touch, often with fever and chills, you should seek medical attention promptly rather than attempting to treat it with over-the-counter products.

Evidence-Based Recommendations

• The 2014 update by the Infectious Diseases Society of America recommends that typical cases of cellulitis without systemic signs of infection should receive an antimicrobial agent that is active against streptococci 1.
• The recommended duration of antimicrobial therapy is 5 days, but treatment should be extended if the infection has not improved within this time period 1.
• Vancomycin or another antimicrobial effective against both MRSA and streptococci is recommended for patients whose cellulitis is associated with penetrating trauma, evidence of MRSA infection elsewhere, nasal colonization with MRSA, injection drug use, or SIRS (severe nonpurulent) 1.

From the FDA Drug Label

PRINCIPAL DISPLAY PANEL - 28.4 g Tube Carton TopCare health ™ MAXIMUM STRENGTH • OUR PHARMACISTS RECOMMEND • NDC 36800-099-02 Hydrocortisone 1% Cream ANTIPRURITIC (ANTI-ITCH) Intensive Healing Formula † NET WT 1 OZ (28.4 g) The suggested steroid cream for cellulitis is not explicitly mentioned in the provided drug label. However, hydrocortisone 1% cream is an anti-pruritic (anti-itch) cream, and it may not be the most suitable option for treating cellulitis, which is a bacterial skin infection.

• The drug label does not provide information on the use of hydrocortisone 1% cream for cellulitis.
• Cellulitis typically requires antibiotic treatment, not steroid cream. 2

From the Research

Suggested Steroid Cream for Cellulitis

There is no mention of steroid cream in the provided studies as a suggested treatment for cellulitis.

Treatment Options for Cellulitis

• The studies suggest that most patients with cellulitis can be treated with oral antibiotics, such as dicloxacillin or cephalexin, when methicillin-resistant Staphylococcus aureus is not a concern 3, 4.
• The choice of antibiotic should be based on the patient's history, risk factors, and the severity of the clinical presentation 5.
• There is no evidence to support the superiority of any one antibiotic over another, and antibiotics with activity against methicillin-resistant Staphylococcus aureus did not add an advantage 6.

Route and Duration of Antibiotic Therapy

• The route of antibiotic administration (oral or intravenous) does not seem to affect the outcome of treatment for cellulitis 7, 6.
• There is no association between the duration of antibiotic therapy and the outcome of treatment, and treatment duration of longer than 5 days is not supported by evidence 7, 6.