Patients with Class I cellulitis can be managed in the community with oral antibiotics [5,7-9].

Arrange urgent hospital admission if the person:

  • Has Class IV cellulitis (sepsis or severe life-threatening infection, such as necrotizing fasciitis).
  • Has Class III cellulitis (significant systemic upset, such as acute confusion, tachycardia, tachypnoea, hypotension, or unstable comorbidities, or a limb-threatening infection due to vascular compromize).
  • Has severe or rapidly deteriorating cellulitis (for example extensive areas of skin).
  • Is very young (under 1 year of age) or frail.
  • Is immunocompromized.
  • Has significant lymphoedema.
  • Has facial cellulitis (unless very mild).
  • Has suspected orbital or periorbital cellulitis (admit to ophthalmology).
  • Has Class II cellulitis (systemically unwell or systemically well but with a comorbidity).
    • Admission may not be necessary if the facilities and expertise are available in the community to give intravenous antibiotics and monitor the person (check local guidelines).
  • Has symptoms or signs suggesting a more serious illness or condition (such as osteomyelitis, or septic arthritis).

Facial and orbital cellulitis, require urgent assessment by the appropriate specialities because of the high risk of local complications.

General measures

  • The affected limb should be elevated and a bed cradle used
  • Analgesia and antipyretics as required
  • Maintain good hydration
  • Mark the extent of erythema present on admission
  • Non-adherent saline dressings for weeping areas