These guidelines apply only to Wards 116 and 118 at RIE, Ward 20 at WGH and ITU at SJH. They should not be used in any other area of NHS Lothian.

See Cellulitis for uncomplicated cellulitis.

Early surgical debridement is the mainstay of treatment.

Where there is considerable tissue oedema consider cutaneous anthrax particularly in people who inject drugs.

Flucloxacillin 2g every 6 hours IV

AND

Clindamycin 1.2g every 6 hours IV

AND

Gentamicin IV (use NHS Lothian calculator located on AMT intranet page)

AND

Metronidazole 500mg every 8 hours IV

Penicillin allergy contact microbiology and give the non-beta-lactam antibiotics whilst contacting microbiology.