Group A streptococcus

Staphylococcus aureus.

Predisposing factors

Skin abrasions



Eczematous skin

Clinical features

Mild cellulitis

  • Soft tissue redness
  • Warmth and swelling
  • Pain/tenderness
  • No systemic features
  • No significant co-morbidities

Moderate cellulitis

  • Above features plus swelling and tenderness
  • Systemic features eg fever, tachycardia

Severe cellulitis


  • Features above with severe swelling or tenderness
  • Large body surface area involved (eg larger than the patient’s handprint)
  • Marked systemic features (eg fever or hypothermia, tachycardia, tachypnoea, altered conscious state, unwell appearance, hypotension



Swab MCS if there is discharge


Mild cellulitis

Cefalexin 33 mg/kg (max 500 mg) oral tds for 5 days

Moderate cellulitis

Cefalexin 33 mg/kg (max 1 g) oral tds – Max  1gm daily for 5-10 days

Ceftriaxone 50 mg/kg (max 2g) IV daily

Cefazolin 50 mg/kg (max 2g) IV bd

Severe cellulitis

Flucloxacillin 50 mg/kg (max 2 g) IV 6H for 5-10 days







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