Erysipelas
EBM Guidelines
Dec 18, 2023 • Latest change Mar 17, 2025
Table of contents
Extract
- Erysipelas is diagnosed on the basis of clinical presentation and increased inflammatory markers.
- Differential diagnostic alternatives include conditions such as suppurative and necrotising skin infections and infections associated with ischaemia or neuropathic ulcer in patients with diabetes.
- Penicillin administered either orally or parenterally depending on the severity of the disease and the patient’s risk factors is the first-line treatment.
- The duration of treatment depends on the response; antimicrobial treatment of 7–14 days is usually sufficient.
- In recurrent erysipelas, predisposing factors should be treated and prophylactic treatment started, as necessary.
Linked evidence summaries
- There is insufficient evidence on the best antibiotic treatment of erysipelas and cellulitisD
- Penicillin appears to be an effective preventive treatment for recurrent erysipelas and cellulitis of the lower limbs.B
Search terms
A46, Blister, Cellulitis, Clindamycin, Dermatology, Edema, Erysipelas, Fever, Infectious diseases, Penicillin G, Penicillin G, Procaine, Penicillin V, Staphylococcus, Ulcer, antimicrobial therapy, benzathine penicillin, penicillin allergy