The Center For Disease Dynamics, Economics & Policy

Skin & Soft Tissue Infections

Clinical definition:

Bacterial infections of skin and underlying soft tissue including cellulitis and abscess.

 

Preferred antibiotic choice(s)
Drug Formulation Dosage Duration
Cloxacillin (PO) Capsule: 500 mg; 1 g (as sodium salt); Powder for oral liquid: 125 mg (as sodium salt)/5 mL 250 mg 6 hourly 5 days
Alternative antibiotic choices:
Amoxicillin + clavulanic acid (PO)

Used for patients with animal bitesA.

Oral liquid: 125 mg amoxicillin + 31.25 mg clavulanic acid/5 mL AND 250 mg amoxicillin + 62.5 mg clavulanic acid/5 mL; Tablet: 500 mg (as trihydrate) + 125 mg (as potassium salt) 500 mg of amoxicillin component 8 hourly 5 days
Cefalexin (PO) Powder for reconstitution with water: 125 mg/5 mL; 250 mg/5 mL (anhydrous); Solid oral dosage form: 250 mg (as monohydrate) 500 mg 6 hourly 5 days
In case of confirmed drug allergy or medical contraindication
Clindamycin (PO) Capsule: 150 mg (as hydrochloride); Oral liquid: 75 mg/5 mL (as palmitate) 300 mg 8 hourly 5 days

 

A. For patients with suspected animal bite, assess for rabies risk and consider administering a tetanus booster.

 

Principles of Stewardship:

  • Withhold antibiotics for standard, uncomplicated abscess in an otherwise well person if the abscess can be incised and drained.
  • If IV antibiotic therapy is clinically indicated, review patient progress at day 3 of treatment to consider switch from IV to oral therapy.