How is cellulitis without draining wounds or abscess treated?

Updated: Jun 14, 2019
  • Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

In cases of cellulitis without draining wounds or abscess, streptococci continue to be the likely etiology, [2] and beta-lactam antibiotics are appropriate therapy, as noted in the following:

  • In mild cases of cellulitis treated on an outpatient basis, dicloxacillin, amoxicillin, and cephalexin are all reasonable choices.

  • Clindamycin or a macrolide (clarithromycin or azithromycin) are reasonable alternatives in patients who are allergic to penicillin.

  • Levofloxacin may also represent an alternative, but the prevalence of resistant strains has increased, and additional toxicity associated with fluoroquinolones has been recognized. Therefore, fluoroquinolones are best reserved for situations with limited alternatives, such as gram-negative organisms with sensitivity demonstrated by culture. [8, 2]

  • Some clinicians prefer an initial dose of parenteral antibiotic with a long half-life (eg, ceftriaxone followed by an oral agent).


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