Erysipelas is a fiery red, tender, painful plaque with well-demarcated edges and is commonly caused by streptococcal species, usually Staphylococcus pyogenes. S. aureus rarely causes erysipelas. Streptococci are the primary cause of erysipelas. Most facial infections are attributed to group A Streptococcus (GAS), with an increasing percentage of lower extremity infections being caused by non-GAS. The role of S. aureus, and specifically MRSA, remains controversial.

Empiric antibiotic regimens. Normal renal function

One of following oral antibiotics

Cephalexin 500 mg 6-hourly

Amoxicillin-clavulanate 1,2 gr 8-hourly

Levofloxacin 500 mg 24-hourly


In critically ill patient needing intravenous administration

One of following antibiotics

Cefazolin 2 g-8 hourly

Amoxicillin-clavulanate 1,2-2,2 gr 8-hourly

Levofloxacin 500 mg 24-hourly

In patients at risk for CA-MRSA or who do not respond to first line therapy consider anti-MRSA antibiotics

Oral options

Minocycline100 mg 12-hourly

Trimethoprim and sulfamethoxazole 160/800 mg 12-hourly

Doxycycline 100 mg 12-hourly

Clindamycin 300–600 mg 8-hourly (high resistance rate)

Tedizolid 200 mg 24-hourly

Intravenous options

Vancomycin 25–30 mg/kg loading dose then 15–20 mg/kg/dose 8-hourly

Teicoplanin LD 12 mg/kg 12-hourly for 3 doses, then 6 mg/kg 12 hourly

Tigecycline 100 mg as a single dose, then 50 mg 12-hourly

Linezolid 600 mg 12-hourly

Daptomycin 4–6 mg/kg 24-hourly

Ceftaroline 600 mg 12-hourly

Dalbavancin 1000 mg once followed by 500 mg after 1 week or 1500 mg one dose

Tedizolid 200 mg 24-hourly

Televancin 10 mg/kg 24-hourly