This protocol addresses children and young people aged 1 month to under 18 years with erysipelas who have no penicillin allergy and whose infection is not near the eyes or nose — specifically when the first-line antibiotic has not produced the expected early response.
Age 1 month to under 18 years. No penicillin allergy. Infection not near the eyes or nose.
Flucloxacillin is the first-choice oral antibiotic for children aged 1 month and over in this setting. If symptoms have not started to improve within 2 to 3 days of starting Flucloxacillin, the treatment goal has not been met and a different antibiotic approach is required.
Alternative choice antibiotics for severe infection are indicated. The appropriate agent may depend on microbiological results and specialist advice. The complete protocol — including which antibiotic options are available, how they are given, and for how long — is set out in full in the structured regimen.
Symptoms should start to improve within 2 to 3 days of the alternative regimen. If symptoms worsen rapidly or significantly at any time, or do not begin to improve within this window, further medical attention is warranted.