From the Guidelines
For cellulitis, the recommended antibiotic treatment is typically a 5- to 6-day course of antibiotics active against streptococci, such as cephalexin (500 mg orally four times daily) or dicloxacillin (500 mg orally four times daily), as recommended by the American College of Physicians 1. The choice of antibiotic should be based on the severity of the infection and the presence of any underlying conditions, such as penicillin allergies or suspected MRSA infection. Some key points to consider when treating cellulitis include:
- The use of antibiotics that target Staphylococcus aureus and Streptococcus species, which are the most common causative organisms 1
- The consideration of alternative antibiotics, such as clindamycin, for patients with penicillin allergies 1
- The potential need for extended treatment duration (up to 10-14 days) for more severe infections or those that do not improve after 5 days of treatment 1
- The importance of monitoring patients for signs of worsening infection, such as spreading redness, fever, or increasing pain, and adjusting treatment accordingly 1. It is also important to note that the treatment of cellulitis should be individualized based on the specific patient's needs and circumstances, and that the use of antibiotics should be guided by the principles of antimicrobial stewardship to minimize the risk of resistance and other adverse effects 1.
From the FDA Drug Label
Clindamycin is indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Anaerobes: ...serious skin and soft tissue infections; ...infections of the female pelvis and genital tract such as ...pelvic cellulitis The recommended antibiotic for cellulitis is clindamycin (PO), specifically for pelvic cellulitis or other serious skin and soft tissue infections caused by susceptible anaerobic bacteria, streptococci, pneumococci, or staphylococci 2.
- Key considerations:
- Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin
- Clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
- Local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy