Cellulitis is a common and potentially serious bacterial skin infection that causes alarming symptoms: redness, warmth, swelling, and pain in the affected area, most often the legs. This condition can feel acutely uncomfortable and interfere with walking and daily routines. Because the infection affects the deeper layers of the skin, it is important to treat it immediately to prevent the bacteria from spreading.

Treatment is essential to stop the infection from entering the bloodstream, which can lead to life-threatening sepsis, or from spreading into deeper soft tissues. The success of treatment depends heavily on how quickly it is started and whether the medication targets the specific bacteria causing the infection. While many mild cases respond well to outpatient care, severe or spreading infections may require hospitalization. Medication choices vary based on the patient’s overall health and the severity of the symptoms (Mayo Clinic, 2024).

Overview of treatment options for Cellulitis

The definitive treatment for cellulitis is medication that targets and eliminates the bacterial cause. The main goal is to clear the infection and reduce the accompanying inflammation.

For most people with mild to moderate cellulitis, treatment involves a course of oral antibiotics taken at home. However, if the infection is spreading quickly, if the patient has a high fever, or if they have underlying conditions that compromise their immune system (such as diabetes), the infection is considered severe and may require intravenous (IV) antibiotics in a hospital setting. Supportive measures, such as elevating the affected limb and using pain medication, are also a crucial part of the healing process alongside the antibiotics.

Medications used for Cellulitis

Antibiotics are the essential first-line drug class for cellulitis. The choice depends on the bacteria suspected to be responsible. Most common cellulitis infections are caused by Streptococcus and certain types of Staphylococcus bacteria.

For simple, community-acquired infections, doctors typically prescribe antibiotics from the penicillin class (like amoxicillin) or cephalosporins (like cephalexin). These are generally broad-spectrum enough to cover the expected pathogens. If the infection is severe, recurrent, or suspected to involve drug-resistant organisms like Methicillin-Resistant Staphylococcus Aureus (MRSA), stronger antibiotics are required, such as clindamycin or trimethoprim-sulfamethoxazole.

For symptom relief, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are used to manage pain, reduce swelling, and lower fever. Patients should generally expect to see the fever and pain begin to subside within 48 to 72 hours of starting antibiotic treatment. However, the redness and swelling take much longer, sometimes up to two weeks to completely resolve (Centers for Disease Control and Prevention, 2024).

How these medications work

Antibiotics function as a defense against the invading bacteria. Many common antibiotic classes work by interfering with the bacteria’s ability to maintain their structural integrity. For example, some drugs prevent the bacteria from building a cell wall, causing the harmful germs to rupture and die. Other antibiotics interrupt the bacteria’s ability to produce necessary proteins or replicate their DNA, effectively stopping the infection from growing and spreading.

NSAIDs work differently; they do not kill the bacteria. Instead, they provide supportive care by blocking the production of chemical compounds in the body called prostaglandins. Since prostaglandins are responsible for pain, fever, and inflammation, blocking them helps reduce the uncomfortable symptoms of cellulitis, allowing the patient to rest and recover more easily.

Side effects and safety considerations

Antibiotics, while curative, commonly cause general side effects such as nausea, diarrhea, and stomach upset. It is extremely important to complete the entire course of medication as prescribed, even if the symptoms disappear, to prevent the infection from returning or developing resistance.

Patients with known allergies to penicillin must inform their provider, as certain classes of antibiotics should be avoided. Some stronger antibiotics carry a risk of severe diarrhea caused by a bacterium known as C. difficile. Patients should seek immediate medical care if the area of redness and warmth rapidly expands, if they develop a high fever and chills, or if the skin starts to blister, which may indicate a more severe deep-tissue infection (MedlinePlus, 2022).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. Centers for Disease Control and Prevention. https://www.cdc.gov
  2. Mayo Clinic. https://www.mayoclinic.org
  3. MedlinePlus. https://medlineplus.gov
  4. National Institutes of Health. https://www.nih.gov

Medications for Cellulitis

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Cellulitis.

Found 3 Approved Drugs for Cellulitis

Clindamycin

Brand Names
ClindaCare, Cleocin, Xaciato, Neuac, Clindacin ETZ, Tretinion, Clindesse, Clindacin, Tretinoin, Clindamycin Phoaphate, Altreno, Benzaclin, Atralin, Twyneo, ZIANA, Tri-Luma, Vesanoid, Retin-A, Clindagel, Acanya, Renova, Onexton

Clindamycin

Brand Names
ClindaCare, Cleocin, Xaciato, Neuac, Clindacin ETZ, Tretinion, Clindesse, Clindacin, Tretinoin, Clindamycin Phoaphate, Altreno, Benzaclin, Atralin, Twyneo, ZIANA, Tri-Luma, Vesanoid, Retin-A, Clindagel, Acanya, Renova, Onexton
TWYNEO is indicated for the topical treatment of acne vulgaris in adults and pediatric patients 9 years of age and older. TWYNEO is a combination tretinoin, a retinoid, and benzoyl peroxide indicated for the topical treatment of acne vulgaris in adults and pediatric patients 9 years of age and older. ( 1 )

Ceftazidime

Brand Names
Tazicef, Avycaz

Ceftazidime

Brand Names
Tazicef, Avycaz
Tazicef (ceftazidime for injection) is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases: 1. Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp.; Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis ; Escherichia coli ; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae ; and Staphylococcus aureus (methicillin-susceptible strains). 2. Skin and Skin-Structure Infections caused by Pseudomonas aeruginosa ; Klebsiella spp.; Escherichia coli ; Proteus spp., including Proteus mirabilis and indole-positive Proteus ; Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin-susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci). 3. Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa ; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus ; Klebsiella spp.; and Escherichia coli. 4. Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae, and S taphylococcus aureus (methicillin-susceptible strains). 5. Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin-susceptible strains). 6. Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli. 7. Intra-abdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin-susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp. (many strains of Bacteroides fragilis are resistant). 8. Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis. Ceftazidime has also been used successfully in a limited number of cases of meningitis due to Pseudomonas aeruginosa and Streptococcus pneumoniae. Tazicef (ceftazidime for injection, USP) may be used alone in cases of confirmed or suspected sepsis. Ceftazidime has been used successfully in clinical trials as empiric therapy in cases where various concomitant therapies with other antibacterial drugs have been used. Tazicef may also be used concomitantly with other antibacterial drugs, such as aminoglycosides, vancomycin, and clindamycin; in severe and life-threatening infections; and in the immunocompromised patient. When such concomitant treatment is appropriate, prescribing information in the labeling for the other antibacterial drugs should be followed. The dose depends on the severity of the infection and the patient's condition. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Tazicef (ceftazidime) and other antibacterial drugs, Tazicef (ceftazidime) should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Cefoxitin

Generic Name
Cefoxitin

Cefoxitin

Generic Name
Cefoxitin
Treatment: CEFOXITIN FOR INJECTION, USP is indicated for the treatment of serious infections caused by susceptible strains of the designated microorganisms in the diseases listed below. Lower respiratory tract infections, including pneumonia and lung abscess, caused by Streptococcus pneumoniae, other streptococci (excluding enterococci, e.g., Enterococcus faecalis [formerly Streptococcus faecalis ]), Staphylococcus aureus (including penicillinase-producing strains), Escherichia coli, Klebsiella species, Haemophilus influenzae, and Bacteroides species. Urinary tract infections caused by Escherichia coli, Klebsiella species, Proteus mirabilis, Morganella morganii, Proteus vulgaris and Providencia species (including P. rettgeri ). Intra-abdominal infections, including peritonitis and intra-abdominal abscess, caused by Escherichia coli, Klebsiella species, Bacteroides species including Bacteroides fragilis, and Clostridium species. Gynecological infections, including endometritis, pelvic cellulitis, and pelvic inflammatory disease caused by Escherichia coli, Neisseria gonorrhoeae (including penicillinase-producing strains), Bacteroides species including B. fragilis, Clostridium species, Peptococcus niger, Peptostreptococcus species, and Streptococcus agalactiae. CEFOXITIN FOR INJECTION, USP, like cephalosporins, has no activity against Chlamydia trachomatis. Therefore, when CEFOXITIN FOR INJECTION, USP is used in the treatment of patients with pelvic inflammatory disease and C. trachomatis is one of the suspected pathogens, appropriate anti-chlamydial coverage should be added. Septicemia caused by Streptococcus pneumoniae, Staphylococcus aureus (including penicillinase-producing strains), Escherichia coli, Klebsiella species, and Bacteroides species including B. fragilis. Bone and joint infections caused by Staphylococcus aureus (including penicillinase-producing strains). Skin and skin structure infections caused by Staphylococcus aureus (including penicillinase-producing strains), Staphylococcus epidermidis, Streptococcus pyogenes and other streptococci (excluding enterococci e.g., Enterococcus faecalis [formerly Streptococcus faecalis ]), Escherichia coli, Proteus mirabilis, Klebsiella species, Bacteroides species including B. fragilis, Clostridium species, Peptococcus niger, and Peptostreptococcus species. Appropriate culture and susceptibility studies should be performed to determine the susceptibility of the causative organisms to CEFOXITIN FOR INJECTION, USP. Therapy may be started while awaiting the results of these studies. In randomized comparative studies, CEFOXITIN FOR INJECTION, USP and cephalothin were comparably safe and effective in the management of infections caused by gram-positive cocci and gram-negative rods susceptible to the cephalosporins. CEFOXITIN FOR INJECTION, USP has a high degree of stability in the presence of bacterial beta-lactamases, both penicillinases and cephalosporinases. Many infections caused by aerobic and anaerobic gram-negative bacteria resistant to some cephalosporins respond to CEFOXITIN FOR INJECTION, USP. Similarly, many infections caused by aerobic and anaerobic bacteria resistant to some penicillin antibiotics (ampicillin, carbenicillin, penicillin G) respond to treatment with CEFOXITIN FOR INJECTION, USP. Many infections caused by mixtures of susceptible aerobic and anaerobic bacteria respond to treatment with CEFOXITIN FOR INJECTION, USP. Prevention: CEFOXITIN FOR INJECTION, USP is indicated for the prophylaxis of infection in patients undergoing uncontaminated gastrointestinal surgery, vaginal hysterectomy, abdominal hysterectomy, or cesarean section. If there are signs of infection, specimens for culture should be obtained for identification of the causative organism so that appropriate treatment may be instituted. To reduce the development of drug-resistant bacteria and maintain the effectiveness of CEFOXITIN FOR INJECTION, USP and other antibacterial drugs, CEFOXITIN FOR INJECTION, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
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