What are the medications used to treat cellulitis?

From the Guidelines

Cellulitis should be treated with antibiotics that target streptococci, and the choice of antibiotic should be based on the severity of the infection and the presence of systemic signs of infection, as recommended by the Infectious Diseases Society of America 1. The treatment of cellulitis typically involves the use of oral antibiotics for mild cases, with options including cephalexin (500 mg four times daily), dicloxacillin (500 mg four times daily), or amoxicillin-clavulanate (875/125 mg twice daily) for 5-10 days 1.

• For more severe infections or those involving MRSA, clindamycin (300-450 mg four times daily), trimethoprim-sulfamethoxazole (1-2 double-strength tablets twice daily), or doxycycline (100 mg twice daily) may be used.
• Hospitalization with intravenous antibiotics like vancomycin, ceftriaxone, or piperacillin-tazobactam might be necessary for severe cases, immunocompromised patients, or those with systemic symptoms. While taking antibiotics, it's essential to elevate the affected area, apply warm compresses, and take over-the-counter pain relievers like acetaminophen or ibuprofen for discomfort. 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. In severely compromised patients, broad-spectrum antimicrobial coverage may be considered, with vancomycin plus either piperacillin-tazobactam or imipenem/meropenem as a reasonable empiric regimen for severe infections 1.

From the FDA Drug Label

There is no information in the provided drug labels that directly supports the answer to the question about cellulitis medications.

The FDA drug label does not answer the question.

From the Research

Cellulitis Medications

• The choice of antibiotic for cellulitis treatment depends on various factors, including the likelihood of methicillin-resistant Staphylococcus aureus (MRSA) infection 2, 3.
• A study published in 2010 found that trimethoprim-sulfamethoxazole and clindamycin had higher treatment success rates compared to cephalexin, especially in patients with MRSA infections or moderately severe cellulitis 2.
• Another study published in 2019 found that there is no evidence to support the superiority of any one antibiotic over another, and antibiotics with activity against MRSA did not add an advantage 4.
• A cost-effectiveness analysis published in 2007 found that cephalexin was the most cost-effective option for outpatient empiric therapy of cellulitis, while clindamycin became more cost-effective at high likelihoods of MRSA infection 3.
• The following medications have been studied for the treatment of cellulitis:
  • Trimethoprim-sulfamethoxazole
  • Cephalexin
  • Clindamycin
  • Linezolid (used in cases of clinical failure) 2, 3
• Factors associated with treatment failure include therapy with an antibiotic that is not active against community-associated MRSA and severity of cellulitis 2.