Adult

Facial cellulitis (excluding pinna)

See separate guidelines for Periorbital cellulitisPinna cellulitis / perichondritis

 

Treat for 5 days (review iv daily), can extend to 7 days if slow to settle

See NICE guideline NG141 (revised 2019)

Preferred

flucloxacillin 1g iv qds (increase to 2g iv qds in obese patients) 

For less severe cases or for oral follow on therapy, flucloxacillin 500mg - 1g po qds 

Alternative

For penicillin allergy (non-severe)

cefazolin 1g iv tds (increase to 2g iv tds in obese patients) 

For less severe cases or for oral follow on therapy: cefalexin 1g po tds

 

For penicillin allergy (severe) OR MRSA positive patients:

doxycycline 100mg po bd

OR

co-trimoxazole 960mg po bd (or iv if the oral route unavailable)

Editorial Information

Last reviewed: 01 Mar 2025