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Doxycycline (Vibramycin) for Cellulitis

Cellulitis is a relatively deep skin infection and involves the dermis and subcutaneous tissue and fat layer. A typical symptom is painful swelling with erythema that is hot and tender to touch. Staphylococcus aureus and Streptococcus species are the major causes of cellulitis 1.

Most guidelines for managing mild or moderate cellulitis recommend flucloxacillin, dicloxacillin, or cephalexin as first-line antibiotics3-4. Severe cellulitis may require parenteral therapy.

Doxycycline is a good choice for cellulitis due to S. aureus, particularly methicillin-resistant strains (MRSA), but it has poor anti-streptococcal activity2.

If cellulitis is accompanied by abscess or purulent drainage, there is a greater chance that it could be due to MRSA. Cellulitis by itself, without any abscess, is usually due to Streptococcus species.

Doxycycline dosage for cellulitis: 100 mg twice daily for 10 days.

As doxycycline has poor activity against streptococci it is often combined with amoxicillin or cephalexin.

See also

References

  • 1. Chira S, Miller LG. Staphylococcus aureus is the most common identified cause of cellulitis. Epidemiol Infect. 2010 Mar;138(3):313-7. PubMed
  • 2. Rogers RL, Perkins J. Prim Care. 2006 Sep;33(3):697-710.
  • 3. CREST (2005) Guidelines on the management of cellulitis in adults
  • 4. IDSA Practice Guidelines for the Diagnosis and Management of Skin and Soft-Tissue Infections.

Author: OriginalDrugs Team
Last reviewed: February 2015

Quick facts

Doxycycline
  • Doxycycline is a choice where MRSA infection is suspected.
  • Good hygiene, warm compresses (3-4 times a day for 15 to 20 minutes), and elevation of the affected limb help accelerate healing.