# Cellulitis and erysipelas - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - Sources: Cellulitis and erysipelas - disease-level clinical article (cellulitis-clinical.txt) · IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014 · Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (cephradine monograph) - Verified date: 2026-08 ## Verified against - IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014 - Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) - Egyptian National Drug Formulary - Antimicrobial 2023 (cephradine monograph) - Cellulitis - disease-level clinical article (cellulitis-clinical.txt) ## Treatment metadata - Cefalexin — 500 mg — oral.solid - Cefadroxil — 500 mg — oral.solid - Cephradine — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) - Amoxicillin — 500 mg — oral.solid - Clindamycin — 300 mg — oral.solid - Co-trimoxazole — oral.solid ## Complete treatment card ```text CELLULITIS AND ERYSIPELAS Sources: Cellulitis and erysipelas - disease-level clinical article (cellulitis-clinical.txt) · IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014 · Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (cephradine monograph) Review status: REVIEWED against 3 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (2) - Poorly demarcated, warm, swollen, tender erythema, with fever, malaise, and fatigue in moderate to severe cases [fatigue · fever · malaise · redness] - History should cover recent travel, trauma, IV drug use, and any insect or animal bite to the affected area [animal bite] SIGNS - what you find (5) - Palpate for fluctuance, suggesting a developing abscess, plus warmth, tenderness, or purulent drainage [abscess · pus] - Most often involves the lower extremities - Rarely bilateral; check the toe web spaces in lower-extremity cases for a portal of entry - Check sensation and distal pulses in the affected limb, to screen for compartment syndrome - Note any vesicles, bullae, peau d'orange, or lymphadenopathy [blisters · lymphadenopathy · vesicles] TESTS (2) - IDSA guidance advises against imaging the area, except in patients with febrile neutropenia - Blood cultures are reserved for immunocompromised patients, immersion injuries, animal bites, or signs of systemic infection IF NOT THIS - what else fits (5) - Erysipelas: brighter, sharply demarcated, raised erythema versus cellulitis's flatter, less distinct pink; may streak along lymphatics; first-line treatment is amoxicillin or cephalexin - Chronic venous stasis dermatitis: bilateral and longstanding, centered on the medial malleoli, with scaling, edema, and hyperpigmentation - Septic arthritis: swelling, warmth, pain, and reduced motion, most often at the knee; treated with joint aspiration and antibiotics - Deep vein thrombosis: typically unilateral tenderness, erythema, warmth, and edema - DVT rarely causes fever or leukocytosis; ultrasound confirms the diagnosis Source StatPearls "Cellulitis" - disease-level clinical article Status traced to the source above 1. CEFALEXIN [1st line] Adult 500 mg QID (every 6 hours) or 1 g BID x 5-7 days Peds 25-50 mg/kg/day [child max 2000 mg] (Given in 2-4 divided doses daily (up to 100 mg/kg/day in severe infection)) 3kg -> 75-150 mg/day 4kg -> 100-200 mg/day 5kg -> 125-250 mg/day 6kg -> 150-300 mg/day 7kg -> 175-350 mg/day 8kg -> 200-400 mg/day 9kg -> 225-450 mg/day 10kg -> 250-500 mg/day 11kg -> 275-550 mg/day 12kg -> 300-600 mg/day 13kg -> 325-650 mg/day 14kg -> 350-700 mg/day 15kg -> 375-750 mg/day 16kg -> 400-800 mg/day 17kg -> 425-850 mg/day 18kg -> 450-900 mg/day 19kg -> 475-950 mg/day 20kg -> 500-1000 mg/day 21kg -> 525-1050 mg/day 22kg -> 550-1100 mg/day 23kg -> 575-1150 mg/day 24kg -> 600-1200 mg/day 25kg -> 625-1250 mg/day 26kg -> 650-1300 mg/day 27kg -> 675-1350 mg/day 28kg -> 700-1400 mg/day 29kg -> 725-1450 mg/day 30kg -> 750-1500 mg/day 31kg -> 775-1550 mg/day 32kg -> 800-1600 mg/day 33kg -> 825-1650 mg/day 34kg -> 850-1700 mg/day 35kg -> 875-1750 mg/day 36kg -> 900-1800 mg/day 37kg -> 925-1850 mg/day 38kg -> 950-1900 mg/day 39kg -> 975-1950 mg/day 40kg -> 1000-2000 mg/day 41kg -> 1025-2000 mg/day (upper capped) 42kg -> 1050-2000 mg/day (upper capped) 43kg -> 1075-2000 mg/day (upper capped) 44kg -> 1100-2000 mg/day (upper capped) 45kg -> 1125-2000 mg/day (upper capped) 46kg -> 1150-2000 mg/day (upper capped) 47kg -> 1175-2000 mg/day (upper capped) 48kg -> 1200-2000 mg/day (upper capped) 49kg -> 1225-2000 mg/day (upper capped) 50kg -> 1250-2000 mg/day (upper capped) Choice Alternatives, all first-generation cephalosporins. The entry's rationale names cefalexin the first-line oral beta-lactam, and 8 products carry it. Source IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014 Why First-line oral beta-lactam for non-purulent skin infection Caution Use with caution in severe penicillin hypersensitivity (cross-reactivity risk). Reduce dosage in severe renal impairment (eGFR < 30). Monitor for Clostridioides difficile diarrhea. Egypt CEFLODIX 500 MG 12 CAPS. ARAB CAPS > P... 9.00 EGP (0.75/unit) CEPHALEXCID 500 MG 12 CAPS. CID 10.30 EGP (0.86/unit) CEPHOXIN 500MG 12 TAB. PHARCO B 10.50 EGP (0.88/unit) CEPHALEXIN 500MG 10 CAPS. ARAB DRUG COM... 10.10 EGP (1.01/unit) MEDICEFLEXIN 500 MG 20 CAPS. T3A PHARMA > ... 25.25 EGP (1.26/unit) CEPHALEXIN 500MG 12 CAPS B.P.2007 SHIFA MEDICAL PRODUCTS > O... 27.00 EGP (2.25/unit) KEFLEX 500 MG 12 CAPS. HIKMA PHARMA 58.00 EGP (4.83/unit) CEPOREX 500MG 12 TABS. GLAXO SMITHKLINE 69.00 EGP (5.75/unit) AMTHROST 125MG/5ML SUSP. 60ML SIGMA > SABAA 4.00 EGP -> ? strength differs, ? different route - not oral solid AMTHROST 250MG/5ML SUSP. 60ML SIGMA > SABAA 4.50 EGP -> ? strength differs, ? different route - not oral solid 2. CEFADROXIL [1st line] Adult 500 mg to 1 g BID (every 12 hours) x 5-7 days Peds 30-50 mg/kg/day [child max 2000 mg] (Given in 1-2 divided doses daily) 3kg -> 90-150 mg/day 4kg -> 120-200 mg/day 5kg -> 150-250 mg/day 6kg -> 180-300 mg/day 7kg -> 210-350 mg/day 8kg -> 240-400 mg/day 9kg -> 270-450 mg/day 10kg -> 300-500 mg/day 11kg -> 330-550 mg/day 12kg -> 360-600 mg/day 13kg -> 390-650 mg/day 14kg -> 420-700 mg/day 15kg -> 450-750 mg/day 16kg -> 480-800 mg/day 17kg -> 510-850 mg/day 18kg -> 540-900 mg/day 19kg -> 570-950 mg/day 20kg -> 600-1000 mg/day 21kg -> 630-1050 mg/day 22kg -> 660-1100 mg/day 23kg -> 690-1150 mg/day 24kg -> 720-1200 mg/day 25kg -> 750-1250 mg/day 26kg -> 780-1300 mg/day 27kg -> 810-1350 mg/day 28kg -> 840-1400 mg/day 29kg -> 870-1450 mg/day 30kg -> 900-1500 mg/day 31kg -> 930-1550 mg/day 32kg -> 960-1600 mg/day 33kg -> 990-1650 mg/day 34kg -> 1020-1700 mg/day 35kg -> 1050-1750 mg/day 36kg -> 1080-1800 mg/day 37kg -> 1110-1850 mg/day 38kg -> 1140-1900 mg/day 39kg -> 1170-1950 mg/day 40kg -> 1200-2000 mg/day 41kg -> 1230-2000 mg/day (upper capped) 42kg -> 1260-2000 mg/day (upper capped) 43kg -> 1290-2000 mg/day (upper capped) 44kg -> 1320-2000 mg/day (upper capped) 45kg -> 1350-2000 mg/day (upper capped) 46kg -> 1380-2000 mg/day (upper capped) 47kg -> 1410-2000 mg/day (upper capped) 48kg -> 1440-2000 mg/day (upper capped) 49kg -> 1470-2000 mg/day (upper capped) 50kg -> 1500-2000 mg/day (upper capped) Source Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph) Why Convenient twice-daily dosing alternative to cephalexin Caution Caution in penicillin hypersensitivity. Adjust dose in renal impairment. Take with food if gastric irritation occurs. The Egyptian formulary gives 1 g daily, as a single dose or two divided doses, for skin and skin structure infection - the lower end of this range. It allows 1 g twice daily only for complicated urinary infection. Egypt MEGADROXIL 500 MG 8 CAPS. SHIFA MEDICAL... 4.50 EGP (0.56/unit) CEFADROXIL 500MG 8 CAPS. SIGMA 7.50 EGP (0.94/unit) DURABIOTIC 500MG 8 CAPS. LOGESTIC PHAR... 9.00 EGP (1.12/unit) BIODROXIL 500MG 8 CAPS. KAHIRA > NOVA... 10.50 EGP (1.31/unit) LONGICEF 500 MG 8 CAPS. KAHIRA 15.00 EGP (1.88/unit) CURISAFE 500MG 8 CAPS. PHARCO B 45.00 EGP (5.62/unit) DURICEF 500MG 12 CAPS. SMITHKLINE BE... 72.00 EGP (6.00/unit) LONGICEF 125MG/5ML SUSP. 60 ML KAHIRA 4.25 EGP -> ? strength differs, ? different route - not oral solid CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML SIGMA 7.50 EGP -> ? strength differs, ? different route - not oral solid 3. CEPHRADINE [1st line] Adult 500 mg every 6 hours (1-2 g daily in 2-4 divided doses); up to 4 g daily in more extensive infection - Match the 5-7 day course used for cefalexin in this condition - the formulary monograph does not state a duration Peds 25-50 mg/kg/day [child max 4000 mg] (25-50 mg/kg/day orally in 2 or 4 divided doses. Suspension 125 mg/5 mL and 250 mg/5 mL. The higher 75-100 mg/kg/day band in the monograph is for otitis media, not skin infection.) 3kg -> 75-150 mg/day 4kg -> 100-200 mg/day 5kg -> 125-250 mg/day 6kg -> 150-300 mg/day 7kg -> 175-350 mg/day 8kg -> 200-400 mg/day 9kg -> 225-450 mg/day 10kg -> 250-500 mg/day 11kg -> 275-550 mg/day 12kg -> 300-600 mg/day 13kg -> 325-650 mg/day 14kg -> 350-700 mg/day 15kg -> 375-750 mg/day 16kg -> 400-800 mg/day 17kg -> 425-850 mg/day 18kg -> 450-900 mg/day 19kg -> 475-950 mg/day 20kg -> 500-1000 mg/day 21kg -> 525-1050 mg/day 22kg -> 550-1100 mg/day 23kg -> 575-1150 mg/day 24kg -> 600-1200 mg/day 25kg -> 625-1250 mg/day 26kg -> 650-1300 mg/day 27kg -> 675-1350 mg/day 28kg -> 700-1400 mg/day 29kg -> 725-1450 mg/day 30kg -> 750-1500 mg/day 31kg -> 775-1550 mg/day 32kg -> 800-1600 mg/day 33kg -> 825-1650 mg/day 34kg -> 850-1700 mg/day 35kg -> 875-1750 mg/day 36kg -> 900-1800 mg/day 37kg -> 925-1850 mg/day 38kg -> 950-1900 mg/day 39kg -> 975-1950 mg/day 40kg -> 1000-2000 mg/day 41kg -> 1025-2050 mg/day 42kg -> 1050-2100 mg/day 43kg -> 1075-2150 mg/day 44kg -> 1100-2200 mg/day 45kg -> 1125-2250 mg/day 46kg -> 1150-2300 mg/day 47kg -> 1175-2350 mg/day 48kg -> 1200-2400 mg/day 49kg -> 1225-2450 mg/day 50kg -> 1250-2500 mg/day Source Egyptian National Drug Formulary - Antimicrobial 2023 (cephradine monograph) Why 30 live products. The formulary indication covers infections of skin and skin structure, and cephradine is interchangeable with the cefalexin and cefadroxil already listed - it is here because it is what is actually on the pharmacy shelf in much of Cairo. Caution No activity against MRSA - if the infection is purulent, recurrent, or fails to respond in 48-72 hours, reconsider the organism. An abscess needs incision and drainage; no oral cephalosporin substitutes for that. Avoid in immediate-type penicillin allergy. Renal impairment: 500 mg every 6 hours if creatinine clearance is above 20 mL/min, 250 mg every 6 hours at 5-20 mL/min, 250 mg every 12 hours below 5 mL/min Clinically it adds nothing over the cefalexin already listed - choose on price and availability, not on spectrum. Mark the edge of the erythema with a pen and review in 48 hours. Egypt CEFADRIN 500MG 12CAPS. UP PHARMA 11.00 EGP (0.92/unit) VELOSEF 500MG 16 CAPS. SMITHKLINE BE... 118.00 EGP (7.38/unit) MEPADRIN 125MG/5ML GR. FOR ORAL 60ML SUSP. CHEMIPHARM 7.00 EGP -> ? strength differs, ? different route - not oral solid CEFADRINE 125MG/5ML 60ML SUSP. UP PHARMA 7.50 EGP -> ? strength differs, ? different route - not oral solid 4. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Cellulitis - disease-level clinical article (cellulitis-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Systemic signs of infection (SIRS criteria: fever, tachycardia, tachypnea, abnormal WBC) should prompt hospitalization and IV antibiotics rather than oral therapy. RED FLAG - The admission criteria are failed outpatient treatment, an immunocompromised patient, rapidly progressing erythema, inability to tolerate oral medication, or cellulitis near an indwelling device. RED FLAG - Necrotizing fasciitis red flags (pain out of proportion, crepitus) require immediate surgical referral, not oral antibiotics. RED FLAG - Diabetic patients / diabetic foot ulcers are at risk for Pseudomonas aeruginosa, which a cephalosporin alone does not cover. 5. AMOXICILLIN [1st line] Adult Erysipelas, mild: Oral: 500 mg 3 times or 875 mg every 12 hours for 5 days, for up to 14 days x 5 days, for up to 14 days Peds 20-40 mg/kg/day [child max 1500 mg] (Children >3 months (mild to moderate infection): Oral: 20 to 40 mg/kg/day in divided doses every 8 hours (maximum 500 mg/dose) or 25 to 45 mg/kg/day in divided doses every 12 hours (maximum 875 mg/dose).) 3kg -> 60-120 mg/day 4kg -> 80-160 mg/day 5kg -> 100-200 mg/day 6kg -> 120-240 mg/day 7kg -> 140-280 mg/day 8kg -> 160-320 mg/day 9kg -> 180-360 mg/day 10kg -> 200-400 mg/day 11kg -> 220-440 mg/day 12kg -> 240-480 mg/day 13kg -> 260-520 mg/day 14kg -> 280-560 mg/day 15kg -> 300-600 mg/day 16kg -> 320-640 mg/day 17kg -> 340-680 mg/day 18kg -> 360-720 mg/day 19kg -> 380-760 mg/day 20kg -> 400-800 mg/day 21kg -> 420-840 mg/day 22kg -> 440-880 mg/day 23kg -> 460-920 mg/day 24kg -> 480-960 mg/day 25kg -> 500-1000 mg/day 26kg -> 520-1040 mg/day 27kg -> 540-1080 mg/day 28kg -> 560-1120 mg/day 29kg -> 580-1160 mg/day 30kg -> 600-1200 mg/day 31kg -> 620-1240 mg/day 32kg -> 640-1280 mg/day 33kg -> 660-1320 mg/day 34kg -> 680-1360 mg/day 35kg -> 700-1400 mg/day 36kg -> 720-1440 mg/day 37kg -> 740-1480 mg/day 38kg -> 760-1500 mg/day (upper capped) 39kg -> 780-1500 mg/day (upper capped) 40kg -> 800-1500 mg/day (upper capped) 41kg -> 820-1500 mg/day (upper capped) 42kg -> 840-1500 mg/day (upper capped) 43kg -> 860-1500 mg/day (upper capped) 44kg -> 880-1500 mg/day (upper capped) 45kg -> 900-1500 mg/day (upper capped) 46kg -> 920-1500 mg/day (upper capped) 47kg -> 940-1500 mg/day (upper capped) 48kg -> 960-1500 mg/day (upper capped) 49kg -> 980-1500 mg/day (upper capped) 50kg -> 1000-1500 mg/day (upper capped) Source Egyptian National Drug Formulary - Antimicrobial 2023 Why First-line oral aminopenicillin for mild erysipelas. Caution Serious hypersensitivity to amoxicillin or to other beta-lactams, or any component of the formulation. Egypt AMOXYCILLIN 500MG 10 CAPS B.P.2013 ARAB DRUG COMPANY (ADCO) 6.50 EGP (0.65/unit) AMOXICILLIN 500MG 12 CAPS. USP 28 OCTOBER PHARMA 8.10 EGP (0.67/unit) AMOXIL 500MG 12 CAPS. MUP > SMITHKL... 9.00 EGP (0.75/unit) AMOXICID 500 MG 12 CAPS. CID 9.50 EGP (0.79/unit) E-MOX 500 MG 16 CAPS. EIPICO 15.60 EGP (0.97/unit) HICONCIL 500MG 12 CAPS. PHARCO 11.60 EGP (0.97/unit) BIOMOX 500MG 12 CAPS. SEDICO 19.50 EGP (1.62/unit) IBIAMOX 500 MG 12 CAPS. AMOUN 45.00 EGP (3.75/unit) HICILLIN 125MG/5ML SUSP. 80ML EL NASR 3.00 EGP -> ? strength differs, ? different route - not oral solid AMOXIL FORT 250MG/5ML SUSP. 60ML MUP > SMITHKL... 5.50 EGP -> ? strength differs, ? different route - not oral solid 6. CLINDAMYCIN [2nd line] Adult 300–450 mg every 6 hours Peds 8-20 mg/kg/day (Children (oral, capsule): 8 to 20 mg/kg/day divided every 6 to 8 hours.) 3kg -> 24-60 mg/day 4kg -> 32-80 mg/day 5kg -> 40-100 mg/day 6kg -> 48-120 mg/day 7kg -> 56-140 mg/day 8kg -> 64-160 mg/day 9kg -> 72-180 mg/day 10kg -> 80-200 mg/day 11kg -> 88-220 mg/day 12kg -> 96-240 mg/day 13kg -> 104-260 mg/day 14kg -> 112-280 mg/day 15kg -> 120-300 mg/day 16kg -> 128-320 mg/day 17kg -> 136-340 mg/day 18kg -> 144-360 mg/day 19kg -> 152-380 mg/day 20kg -> 160-400 mg/day 21kg -> 168-420 mg/day 22kg -> 176-440 mg/day 23kg -> 184-460 mg/day 24kg -> 192-480 mg/day 25kg -> 200-500 mg/day 26kg -> 208-520 mg/day 27kg -> 216-540 mg/day 28kg -> 224-560 mg/day 29kg -> 232-580 mg/day 30kg -> 240-600 mg/day 31kg -> 248-620 mg/day 32kg -> 256-640 mg/day 33kg -> 264-660 mg/day 34kg -> 272-680 mg/day 35kg -> 280-700 mg/day 36kg -> 288-720 mg/day 37kg -> 296-740 mg/day 38kg -> 304-760 mg/day 39kg -> 312-780 mg/day 40kg -> 320-800 mg/day 41kg -> 328-820 mg/day 42kg -> 336-840 mg/day 43kg -> 344-860 mg/day 44kg -> 352-880 mg/day 45kg -> 360-900 mg/day 46kg -> 368-920 mg/day 47kg -> 376-940 mg/day 48kg -> 384-960 mg/day 49kg -> 392-980 mg/day 50kg -> 400-1000 mg/day Choice Clindamycin is the first choice here; co-trimoxazole is a further option. Source Egyptian National Drug Formulary - Antimicrobial 2023 Why Alternative oral lincosamide antibiotic for non-purulent cellulitis in patients with severe beta-lactam allergy. Caution Hypersensitivity to clindamycin, lincomycin, or any component of the formulation. Potential to cause Clostridioides difficile-associated diarrhea. Egypt ADCOCLINDACE 300 MG 16 CAPS. ARAB DRUG COM... 24.00 EGP (1.50/unit) CLINACYN 300MG 16 CAPS. SIGMA > EGYPT... 31.50 EGP (1.97/unit) CLINDAM 300 MG 16 CAPS. SIGMA > OCTOB... 75.00 EGP (4.69/unit) MEPACLIND 300MG 8 CAPS. MEPACO 38.00 EGP (4.75/unit) CLINDACINE ART 300 MG 12 CAPS. RAMEDA > ART ... 76.00 EGP (6.33/unit) ALFACLINDAMYCIN 300 MG 10 CAPS. ATCO PHARMA >... 69.00 EGP (6.90/unit) DALACIN C 300MG 10 CAPS. PFIZER 114.00 EGP (11.40/unit) KLENDABIOTICAM 1 % TOP. SOLUTION PANAX PHARMA 8.50 EGP -> ? strength differs, ? different route - not oral solid ADCOCLINDACE 10MG/ML TOP. SOL. ARAB DRUG COM... 12.00 EGP -> ? strength differs, ? different route - not oral solid 7. CO-TRIMOXAZOLE [2nd line] Adult 800 mg/160 mg twice daily x 5 days Peds 6-12 mg/kg/day [child max 320 mg] (General dosing, susceptible infection: Infants ≥2 months, Children, and Adolescents: Oral, IV: 6 to 12 mg TMP/kg/day in divided doses every 12 hours; maximum single dose: 160 mg TMP/dose.) 3kg -> 18-36 mg/day 4kg -> 24-48 mg/day 5kg -> 30-60 mg/day 6kg -> 36-72 mg/day 7kg -> 42-84 mg/day 8kg -> 48-96 mg/day 9kg -> 54-108 mg/day 10kg -> 60-120 mg/day 11kg -> 66-132 mg/day 12kg -> 72-144 mg/day 13kg -> 78-156 mg/day 14kg -> 84-168 mg/day 15kg -> 90-180 mg/day 16kg -> 96-192 mg/day 17kg -> 102-204 mg/day 18kg -> 108-216 mg/day 19kg -> 114-228 mg/day 20kg -> 120-240 mg/day 21kg -> 126-252 mg/day 22kg -> 132-264 mg/day 23kg -> 138-276 mg/day 24kg -> 144-288 mg/day 25kg -> 150-300 mg/day 26kg -> 156-312 mg/day 27kg -> 162-320 mg/day (upper capped) 28kg -> 168-320 mg/day (upper capped) 29kg -> 174-320 mg/day (upper capped) 30kg -> 180-320 mg/day (upper capped) 31kg -> 186-320 mg/day (upper capped) 32kg -> 192-320 mg/day (upper capped) 33kg -> 198-320 mg/day (upper capped) 34kg -> 204-320 mg/day (upper capped) 35kg -> 210-320 mg/day (upper capped) 36kg -> 216-320 mg/day (upper capped) 37kg -> 222-320 mg/day (upper capped) 38kg -> 228-320 mg/day (upper capped) 39kg -> 234-320 mg/day (upper capped) 40kg -> 240-320 mg/day (upper capped) 41kg -> 246-320 mg/day (upper capped) 42kg -> 252-320 mg/day (upper capped) 43kg -> 258-320 mg/day (upper capped) 44kg -> 264-320 mg/day (upper capped) 45kg -> 270-320 mg/day (upper capped) 46kg -> 276-320 mg/day (upper capped) 47kg -> 282-320 mg/day (upper capped) 48kg -> 288-320 mg/day (upper capped) 49kg -> 294-320 mg/day (upper capped) 50kg -> 300-320 mg/day (upper capped) Source Cellulitis and erysipelas - disease-level clinical article (cellulitis-clinical.txt) for the adult "trimethoprim-sulfamethoxazole 800 mg/160 mg twice daily for 5 days"; the paediatric weight band is from Egyptian National Drug Formulary - Antimicrobial 2023 (sulfamethoxazole and trimethoprim monograph): "6 to 12 mg TMP/kg/day in divided doses every 12 hours; maximum single dose: 160 mg TMP/dose", which the clinical article does not carry. Why Oral anti-MRSA antibiotic coverage for purulent cellulitis or cellulitis with MRSA risk factors. Caution CONTRAINDICATED in hypersensitivity to sulfa drugs or trimethoprim, history of drug- induced immune thrombocytopenia with sulfonamides or trimethoprim, megaloblastic anemia due to folate deficiency, infants <2 months, marked hepatic damage, or severe renal disease if unmonitored. CONTRAINDICATED in blood dyscrasias, pregnancy, breastfeeding, premature infants, and acute porphyria. Avoidance of sulfamethoxazole/trimethoprim during the third trimester is recommended by some guidelines. Discontinue use at first sign of rash due to risk of fatal dermatologic reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis. Egypt CO-TRIMOXAZOLE 20 TABS. MUP 5.00 EGP (0.25/unit) COTRIL 400/80MG 20 TAB. EL NASR 38.00 EGP (1.90/unit) SEPTAZOLE FORTE 800/160MG 20 TABS. ALEXANDRIA 56.00 EGP (2.80/unit) SEPTRIN D.S 10 TABS. GLAXO SMITHKL... 28.00 EGP (2.80/unit) SEPTAZOLE 400/80MG 20*10 TABS. ALEXANDRIA 340.00 EGP (34.00/unit) SUTRIM 400/80MG 20*10 TAB. MEMPHIS 340.00 EGP (34.00/unit) CO-TRIMOXAZOLE 200/40MG SUSP. 120ML MUP 6.00 EGP -> ? strength differs, ? different route - not oral solid SUTRIM 200/40MG SUSP. 100ML MEMPHIS 18.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)