First, it is crucial for the doctor to distinguish whether or not the inflammation is due to an infection. The history and physical exam can provide clues in this regard, as can sometimes an elevated white blood cell count. A culture for bacteria may also be of value in making a diagnosis, but in many cases of
cellulitis, the concentration of bacteria may be low and cultures fail to demonstrate the causative organism. In this situation, cellulitis is commonly treated with antibiotics that are designed to eradicate the most likely bacteria to cause the particular form of cellulitis. If an abscess is present, surgical drainage is typically required.
When it is difficult or impossible to distinguish whether or not the symptoms are due to an infection, doctors sometimes treat with antibiotics just to be sure. If the condition does not respond, it may need to be addressed by different methods dealing with types of inflammation that are not infected. For example, if the inflammation is thought to be due to an autoimmune disorder, treatment may be with a corticosteroid.
Antibiotics, such as derivatives of penicillin or other types of antibiotics that are effective against the responsible bacteria, are used to treat cellulitis. If the bacteria turn out to be resistant to the chosen antibiotics, or in patients who are allergic to penicillin, other appropriate antibiotics can be substituted. Sometimes the treatment requires the administration of intravenous antibiotics in a hospital setting, since oral antibiotics may not always provide sufficient penetration of the inflamed tissues to be effective. In certain cases, intravenous antibiotics can be administered at home or at an infusion center.
The following are some examples of antibiotics that have been used to treat cellulitis:
- Penicillins
- Amoxicillin
- Amoxicillin and clavulanate (Augmentin)
- Ampicillin and sulbactam (Unasyn)
- Piperacillin and tazobactam (Zosyn)
- Cefazolin
- Cephalexin (Keflex)
- Ceftriaxone (Rocephin)
- Cefuroxime (Ceftin, Zinacef)
- Ceftazidime (Fortaz, Tazicef)
- Azithromycin (Zithromax, Zmax)
- Erythromycin (Erythrocin, E.E.S., Ery-Tab, EryPed)
- Imipenem and cilastatin (Primaxin)
- Levofloxacin (Levaquin)
- Ciprofloxacin (Cipro)
- Vancomycin
