This protocol applies to patients with erysipelas or cellulitis presenting without systemic signs of infection — the mild-presentation group — in whom the first-line outpatient course has not produced the expected clinical response.
The initial approach for this mild presentation is oral antimicrobial therapy active against streptococci, given for 5 days (extended when not improved). Escalation to the next treatment step is triggered when clinical improvement of the infection is not observed within 5 days of oral treatment.
After failure of oral outpatient therapy, the protocol calls for hospitalization with intravenous systemic antibiotic therapy. The specific agent selection and full clinical algorithm are available in the complete protocol below.