Children - extremities
- Elevation of affected limb essential:
lower extremity – elevate higher than hip joint
upper extremity – elevate higher than shoulder
For severe infections or those unresponsive to listed empiric therapy, assess for additional risk factors. See Recommended Empiric Therapy of Selected Infections in Adult Patients, Cellulitis/abscess - unresponsive risk factors.
Group A Streptococci
S. aureus
Mild
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cephalexin | 40mg/kg/d PO div qid | 5 days |
ß-lactam allergy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Clindamycin | 20-40mg/kg/d PO div qid | 5 days |
Moderate-severe
Switch to oral agent when:
resolution of systemic symptoms
no further progression of cellulitis.
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefazolin | 75mg/kg/d IV div q8h | 5-10 days |
| or | ||
| Clindamycin IV/PO | 20-40mg/kg/d IV div q8h or | 5-10 days |
| 20-40mg/kg/d PO div qid |
Outpatient IV Therapy > 2 years old consider
Switch to oral agent when:
- resolution of systemic symptoms
- no further progression of cellulitis.
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Cefazolin | 33mg/kg IV daily (max 2g) | 5-10 days |
| + | ||
|
Probenecid (give 30 minutes prior to cefazolin) |
25mg/kg PO daily (rounded to nearest 125mg; max 1g) |