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Cellulitis & Skin/Soft Tissue Infection Management (IDSA 2014)

Cellulitis & Skin/Soft Tissue Infection Management (IDSA 2014): Suspected SSTI → Clinical Assessment → Purulent or Non-purulent? → Purulent: Abscess/Fur...

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. Start

    Suspected SSTI

    Erythema, warmth, swelling, pain

    1. Action

      Clinical Assessment

      Determine severity and type

      • Purulent (abscess/furuncle) vs Non-purulent (cellulitis)
      • Mark borders, check for fluctuance
      • Assess systemic signs
      1. Decision

        Purulent or Non-purulent?

        1. Action

          Purulent: Abscess/Furuncle

          I&D is primary treatment

          • Incision & Drainage essential
          • Culture wound if severe/recurrent
          • Antibiotics: TMP-SMX DS BID or Doxy 100mg BID x5-10d
          • Add beta-lactam if cellulitis extensive
          1. Decision

            MRSA Risk Factors?

            Prior MRSA, IVDU, healthcare exposure

            1. Action

              Add MRSA Coverage

              If risk factors present

              • TMP-SMX DS 1-2 tabs BID
              • OR Doxycycline 100mg BID
              • OR Clindamycin 300-450mg TID
              • For severe: Vancomycin IV
              1. Decision

                Severity Assessment

                1. Action

                  Outpatient (Mild)

                  Oral antibiotics x5 days

                  1. Action

                    Reassess 48-72h

                    Should see improvement

                    • If worsening: Broaden coverage, imaging, r/o abscess
                    1. Outcome

                      Resolved

                    2. Warning

                      Treatment Failure

                      Broaden, drain, consider alternative dx

                2. Action

                  Inpatient (Moderate-Severe)

                  IV antibiotics

                  • Cefazolin 1-2g IV q8h OR
                  • Vancomycin 15-20mg/kg IV q12h (MRSA)
                3. Warning

                  Concern for Necrotizing?

                  Pain out of proportion, crepitus, rapid spread

                  • See NSTI algorithm
                  • Emergent surgery consultation
        2. Action

          Non-purulent Cellulitis

          Strep likely; beta-lactam coverage

          • Mild: Cephalexin 500mg QID or Dicloxacillin 500mg QID x5d
          • Moderate: Ceftriaxone 1g IV daily
          • Mark borders, elevate extremity
          • Consider DVT if unilateral leg swelling

Guideline Source

IDSA SSTI Guidelines 2014

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • ⚠️ UNVALIDATED DRAFT: This algorithm was AI-generated from guideline summaries and has NOT been reviewed by clinical experts. All doses, thresholds, and pathways MUST be verified against primary sources by qualified clinicians before clinical use. Do not use for patient care without expert validation.
  • MRSA prevalence varies by region
  • Purulent vs non-purulent distinction is key
  • DVT should be ruled out

Applicable Regions

USEU
Version 1Next review: 2027-01-11

Frequently Asked Questions

What is the Cellulitis & Skin/Soft Tissue Infection Management (IDSA 2014)?

The Cellulitis & Skin/Soft Tissue Infection Management (IDSA 2014) is a management clinical algorithm for Infectious Disease. It provides a structured decision tree to guide clinical decision-making, based on IDSA SSTI Guidelines 2014.

What guideline is the Cellulitis & Skin/Soft Tissue Infection Management (IDSA 2014) based on?

This algorithm is based on IDSA SSTI Guidelines 2014 (DOI: 10.1093/cid/ciu444).

What are the limitations of the Cellulitis & Skin/Soft Tissue Infection Management (IDSA 2014)?

Known limitations include: ⚠️ UNVALIDATED DRAFT: This algorithm was AI-generated from guideline summaries and has NOT been reviewed by clinical experts. All doses, thresholds, and pathways MUST be verified against primary sources by qualified clinicians before clinical use. Do not use for patient care without expert validation.; MRSA prevalence varies by region; Purulent vs non-purulent distinction is key; DVT should be ruled out. Individual patient factors may require deviation from these recommendations.

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