Template:Erysipelas antibiotics

Coverage for S. pyogenes

  • Penicillin G 300K U/d IM for <30 kg, 600K to 1 million U/d IM for >30 kg (first line therapy[1]) OR
  • Clindamycin 450mg (5mg/kg) PO q8hrs x 10 days (if PCN allergic) OR
  • Cephalexin 500mg (6.25mg/kg) PO q6hrs x 10 days OR
  • Ceftriaxone 1g (50mg/kg) IV once daily x 10 days OR
  • Levofloxacin 500mg PO/IV daily x 10 days OR
  • Amoxicillin/Clavulanate 500mg PO BID x 10 days (generally reserved for failure of first line therapy)

Bullous Erysipela or MRSA suspected: trimethoprim-sulfamethoxazole, clindamycin, doxycycline, or minocycline

Pediatric

  • Penicillin G <30kg: 300,000 U/day IM; >30kg: 600,000-1 million U/day IM OR
  • Cephalexin 25-50mg/kg/day PO divided q6-8h x 10 days (max 500mg/dose) OR
  • Clindamycin 30mg/kg/day PO divided TID x 10 days (max 1.8g/day) OR
  • Ceftriaxone 50mg/kg IV daily (max 2g) x 10 days
  1. Linke M, Booken N. Risk factors associated with a reduced response in the treatment of erysipelas. J Dtsch Dermatol Ges. 2015 Mar;13(3):217-25.