Cellulitis and erysipelas - Treatments

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Antibiotics for cellulitis
Treatments you might have together with antibiotics

If you have cellulitis or erysipelas and you are treated quickly, you're very likely to make a complete recovery.

Antibiotics cure almost everyone with cellulitis if treatment is started quickly.
Some people need to be treated in hospital.
You may need to have antibiotics as a drip into your veins (also called an intravenous infusion or IV). But you'll probably be given tablets instead when your cellulitis starts to improve.
If your cellulitis is mild, you'll probably just take antibiotic tablets.
The antibiotic you are given will depend on what caused your cellulitis.

We normally rank treatments into categories according to whether they work. But antibiotics are the only treatment for cellulitis. We've looked closely at the research and found that antibiotics are likely to work.

Antibiotics for cellulitis

Antibiotics are drugs that kill bacteria. You can get them on prescription from your doctor.

For cellulitis the antibiotics normally given (and their brand names) are:

benzylpenicillin (Penicillin G, Crystapen)
clindamycin (Dalacin C)
erythromycin (Erythrocin, Erymax)
flucloxacillin (Floxapen)
phenoxymethylpenicillin (Penicillin V).

Most antibiotics come as tablets or a drip, except benzypenicillin which just comes as a drip, and phenoxymethylpenicillin, which just comes as a pill.

Antibiotics help most people with cellulitis. In studies, more than half the people taking them got better.[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] In some studies, everyone who took an antibiotic was cured.[7]

Most antibiotics have side effects. In studies, people taking antibiotics for cellulitis had only mild side effects. These included:

Diarrhoea
Feeling sick and vomiting
Tummy pain
Headaches
Dizziness
Rashes.

Cellulitis can sometimes be caused by insect bites or animal bites. You can also get cellulitis if water (from the sea or a river, for example) gets into cuts or grazes on your skin. If this happens, your doctor will probably give you different antibiotics.[11]

Lots of research has found that all antibiotics seem to work equally well to help most people with cellulitis.[1] [2] [3] [4] [5] [6] [7] [8] [9] [12] People in studies took antibiotics for between five to 13 days.

Treatments you might have together with antibiotics

If you have cellulitis, you'll be given antibiotics. You may also get extra treatment to help you feel better until the antibiotics start working. Painkillers can make you feel more comfortable. Paracetamol reduces pain and can also help if you have a temperature.

If your cellulitis is on your leg or arm, you may be told to keep that limb higher than the rest of your body. This may help the swelling go down.[11] [13]

If your skin starts to blister, or it cracks and weeps, you may be given a dressing or bandage to put on it.[11] [13]

If you have athlete's foot (an infection on your foot caused by a fungus) near the infection, it will need to be treated. This will help to stop the cellulitis coming back.[11] For more information, see Athlete's foot.

References

Vinen J, Hudson B, Chan B, et al. A randomized comparative study of once-daily ceftriaxone and 6-hourly flucloxacillin in the treatment of moderate to severe cellulitis: clinical efficacy, safety and pharmacoeconomic implications. Clinical Drug Investigation. 1996; 12: 221-225.
Grayson ML, McDonald M, Gibson K, et al. Once-daily intravenous cefazolin plus oral probenecid is equivalent to once-daily ceftriaxone plus oral placebo for the treatment of moderate-to-severe cellulitis in adults. Clinical Infectious Diseases. 2002; 34: 1440-1448.
Bernard P, Plantin P, Roger H, et al. Roxithromycin versus penicillin in the treatment of erysipelas in adults: a comparative study. British Journal of Dermatology. 1992; 127: 155-159.
Daniel R, Austad J, Debersaques J, et al. Azithromycin, erythromycin and cloxacillin in the treatment of infections of skin and associated soft tissues. Journal of International Medical Research. 1991; 19: 433-445.
Kiani R. Double-blind, double-dummy comparison of azithromycin and cephalexin in the treatment of skin and skin structure infections. European Journal of Clinical Microbiology and Infectious Diseases. 1991; 10: 880-884.
Tack KJ, Littlejohn TW, Mailloux G, et al. Cefdinir versus cephalexin for the treatment of skin and skin-structure infections. Clinical Therapy. 1998; 20: 244-255.
Tassler H. Comparative efficacy and safety of oral fleroxacin and amoxicillin/clavulanate potassium in skin and soft tissue infections. American Journal of Medicine. 1993; 94: 159S-165S.
Parish LC, Jungkind DL. Systemic anti-microbial therapy for skin and skin structure infections: comparison of fleroxacin and ceftazidime. American Journal of Medicine. 1993; 94: 166S-173S.
Chan JC. Ampicillin-sulbactam versus cefazolin or cefoxitin in the treatment of skin and skin-structure infections of bacterial etiology. Advances in Therapy. 1995; 12: 139-146.
Zeglaoui F, Dziri C, Mokhtar I, et al Intramuscular bipenicillin vs. intravenous penicillin in the treatment of erysipelas in adults: randomized controlled study Journal of the European Academy of Dermatology & Venereology. 2004; 18: 426-428.
Swartz MN. Cellulitis. New England Journal of Medicine. 2004; 350: 904-912.
Leman P, Mukherjee D Flucloxacillin alone or combined with benzylpenicillin to treat lower limb cellulites: a randomised controlled trial.
Clinical Resource Efficiency Support Team (CREST). Guidelines on the management of cellulitis in adults. June 2005. Available at http://www.crestni.org.uk (accessed on 7 January 2008).

Glossary

bacteria: Bacteria are tiny organisms. There are lots of different types. Some are harmful and can cause disease. But some bacteria live in your body without causing any harm.
antibiotics: These medicines are used to help your immune system fight infection. There are a number of different types of antibiotics that work in different ways to get rid of bacteria, parasites and other infectious agents. Antibiotics do not work against viruses.
intravenous infusion: When a medicine or a fluid, such as blood, is fed directly into a vein, it's called an intravenous infusion (or IV). To give you an intravenous infusion, a nurse, technician or a doctor places a narrow plastic tube into a vein (usually in your arm) using a needle. The needle is then removed and the fluid is infused (or dripped) through the tube into the vein.

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.