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Doctors' Answers to "Frequently Asked Questions" - Cellulitis

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Treatment for Cellulitis [posted 1/12/99]
Question: What is the preferred antibiotic for cellulitis.

Answer: We usually use a drug which is good against staph and strep like a cephalosporin, but the macroglyides also work.

Question: What causes cellulitis and what is the treatment?

Answer: Cellulitis is a condition where there is significant and widespread inflammation of any part of the body, usually due to infection by bacteria. The term is more commonly used, however, to refer to inflammation (again, usually due to infection) involving the soft tissues (skin, as well as fat beneath the skin) and not the internal organs of the body. There may be areas of purulent material ('pus') within the areas of swelling or redness.

The involved area of skin and subcutaneous (meaning below the skin) tissues is painful, red, warm, and if left untreated, can steadily spread to other areas.

Causes of cellulitis are quite diverse. Essentially, any break in the skin's defense can become infected. This includes burns, swelling and stretching of the skin, lacerations, bruises, abrasions, animal bites, scratches, or even insect bites (although insect bites get infected less commonly). The specific appearance, behavior, and treatment of a given cellulitis varies with the infecting organism, and the immune defense of the individual patient. In severe cases, untreated cellulitis can progress to skin death (necrosis).

Although many bacteria can cause this disease, the most common causes of cellulitis are bacteria known as the Staphylococcus, and more specifically, Staphylococcus, Epidermis, Pyogenes, or Aureus. In the commonly seen cases of injury to a patient's foot due to stepping on a sharp object while outdoors, or injury while swimming, other bacteria may also be causing the infection. Specific locations on the body are prone to infection with certain organisms, such as fungal infections of the fingernails and/or toenails, for example.

Treatment of this disease involves draining any areas of purulent fluid, and sending this fluid for culture. Antibiotics should be started as soon as possible, using one that would treat the more commonly seen bacteria in the particular situation. For example, is the patient suffering from diabetes mellitus (high blood sugar), do they have a problem with their immune system, or a problem with their blood vessels supplying the area of infection? Depending on the severity of infection, as well as the patient's overall medical history and condition, a physician decides whether the cellulitis warrants intravenous antibiotics in a hospital, or rather with oral antibiotics with office visit follow-up. On occasion, surgery is required as part of total treatment (with antibiotics) for severe cases. If you are concerned about the possibility of having a cellulitis contact your physician, so that appropriate therapy can be started.

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