This protocol addresses erysipelas in children aged 1 month to under 18 years with no penicillin allergy, where the infection is not located near the eyes or nose.
This is a subsequent-line protocol. It applies when alternative antibiotics for severe erysipelas — Co-amoxiclav, Cefuroxime, or Clindamycin — have not achieved the expected outcome: symptoms failing to start improving within 2 to 3 days is the clinical trigger for escalation to this step.
When meticillin-resistant Staphylococcus aureus (MRSA) infection is suspected or confirmed, additional targeted antibiotic coverage is introduced as combination therapy alongside existing treatment. Agent selection is guided by microbiological results and specialist advice. The complete regimen is in the structured protocol.