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Cellulitis or erysipelas: do I need antibiotics?

Cellulitis and erysipelas are skin infections that can be serious. Both infections usually develop when bacteria enter the body through a cut or sore on the skin. Symptoms include redness and swelling that may feel hot and painful and can spread quickly. These infections usually affect the legs but can occur anywhere on the body.  

Using antibiotics when they are not needed means they may not work as well in the future. This is a serious health risk so NICE has written advice about when to offer antibiotics for some common conditions.

Because cellulitis and erysipelas are bacterial infections and can be serious, you should be offered antibiotics.

Your doctor should explain that antibiotics can cause side effects, such as diarrhoea and nausea (feeling sick).

Your symptoms should start to improve within a few days of starting antibiotics. You should see your doctor if you don’t start to feel better 2 to 3 days after you start antibiotics, if your symptoms suddenly get worse at any time (including if the redness or swelling continue to spread) or you feel very unwell. They may refer you to hospital if you have signs of a serious illness.

Your skin may take some time to return to normal after you have finished taking the course of antibiotics.

Where can I find out more?

Decisions about treatment and care are best when they are made together. Your health professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.

The NHS website has more information about:

We have also written information on why antibiotics should be used wisely.

We wrote this guideline with health professionals and members of the public. All the recommendations are based on the best research available.

ISBN: 978-1-4731-3542-0

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