Okay, having made our diagnosis of
cellulitis, let's talk about its management.
First off, pretty much all patients with cellulitis on a limb
are gonna benefit from warm compresses and limb elevation.
Next up, for mild infections, with no history of MRSA, not
immunocompromised and non-purulent cellulitis or erysipelas,
you can get by with just a first
generation cephalosporin like cephalexin.
For mild to moderate conditions, or if there's evidence of
purulence, you should really probably use MRSA coverage.
So doxycycline and clindamycin or Bactrim
would be useful for community-acquired MRSA
whereas for hospitalized patients with moderate to severe
symptoms you're gonna need intravenous vancomycin.
This would also be the case for folks who are immunocompromised
or if they're failing to respond to outpatient antibiotics.
Lastly, for those patients for whom you
are concerned about necrotizing fasciitis,
you may need to get a surgical
consult for surgical exploration
or even if there's just an abscess,
you're gonna want to I&D it
because your antibiotics aren't gonna penetrate
into the abscess without first cutting it open.