Pinna cellulitis / perichondritis
Including complications of piercings or otitis externa.
Treat for 5 days. Can be extended to 7 days, depending on severity and response to treatment.
Pinna cellulitis WITHOUT piercing involvement, and NO evidence of perichondritis and NO evidence of pseudomonas aeruginosa
Preferred
flucloxacillin po (see dosing table)
|
Age |
flucloxacillin oral dose |
|
1 month - 1 year |
62.5mg–125 mg QDS |
|
2 years - 9 years |
125mg–250 mg QDS |
|
10 years - 17 years |
250mg–500 mg QDS |
For severe infection: flucloxacillin 50 mg/kg (Max 2g) iv QDS
Alternative
Non-severe penicillin allergy or unable to swallow tablets: cefalexin 25 mg/kg (Max 1g) po TDS
Severe penicillin allergy or MRSA positive patients: co-trimoxazole po (see dosing table)
|
Age |
co-trimoxazole oral dose |
|
6 weeks to 5 months |
120 mg BD |
|
6 months to 5 years |
240 mg BD |
|
6 years to 11 years |
480 mg BD |
|
12 years to 17 years |
960mg BD |
Pinna cellulitis WITH piercing involvement OR evidence of perichondritis OR pseudomonas aeruginosa on culture
Preferred, including penicillin allergy non-severe: ceftazidime 50 mg/kg (Max 2 g) iv TDS
Review IV daily and switch to oral when possible: ciprofloxacin* 20mg/kg (Max 750mg) po BD
For penicillin allergy (severe)
ciprofloxacin* 20mg/kg (Max 750mg) po BD
OR
ciprofloxacin* 10mg/kg (Max 400mg) iv TDS
* Note: Ciprofloxacin may induce convulsions in patients with or without a history of convulsions – use with caution
Also Note: If patient is prescribed ciprofloxacin ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
For more information about MHRA safety alerts and patient or carer counselling See Fluoroquinolone antibiotics - paediatric position statement