{
  "schema_version": 1,
  "kind": "condition",
  "id": "facial-cellulitis-referral",
  "name": "Facial cellulitis / erysipelas (urgent referral pathway)",
  "category": "infectious",
  "sources": "IDSA Skin and Soft Tissue Infection Guidelines 2014 · Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Cellulitis - StatPearls - NCBI Bookshelf (NBK549770)",
  "review_status": "reviewed",
  "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (Version 1.0), p. 246, ceftriaxone monograph, Prescribing Limits: \"Pediatric Patients Endocarditis or meningitis: Maximum 4 g daily. Most other infections: Maximum 2 g daily.\"",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 720,
      "generic": "Ceftriaxone",
      "line": 1,
      "is_adjunct": false,
      "form": "injection",
      "strength_mg": 1000.0,
      "adult_dose": "1-2 g IV or IM once daily; immediate referral for inpatient parenteral therapy",
      "adult_duration": null,
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (Version 1.0), p. 246, ceftriaxone monograph, Prescribing Limits: \"Pediatric Patients Endocarditis or meningitis: Maximum 4 g daily. Most other infections: Maximum 2 g daily.\"",
      "rationale": "Facial cellulitis carries high risk of cavernous sinus thrombosis and intracranial extension; requires urgent IV therapy",
      "cautions": [
        "Facial cellulitis (especially periorbital/nasolabial fold) requires urgent specialist referral.",
        "Do not mix or co-administer with calcium-containing IV solutions."
      ],
      "peds_mgkg_low": 50.0,
      "peds_mgkg_high": 75.0,
      "peds_max_mg": 2000.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "Child: 50-75 mg/kg once daily IV/IM (max 2000 mg daily); urgent pediatric hospital admission mandatory. The formulary's Prescribing Limits box caps a child at 2 g daily for most infections and 4 g daily for endocarditis or meningitis.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 500,
          "high_mg": 750,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 1000,
          "high_mg": 1500,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 1500,
          "high_mg": 2000,
          "capped": true
        },
        {
          "weight_kg": 40,
          "low_mg": 2000,
          "high_mg": 2000,
          "capped": true
        }
      ],
      "brands": [
        {
          "trade_name": "ZOXIDEL 1 GM PD. FOR I.M. INJ.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > DELTA PHARMA",
          "price_egp": 22.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CEFTRIAXONE SODIUM 1 GM I.M.VIAL (KAHIRA)",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA",
          "price_egp": 29.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ZOXIDEL 1 GM PD. FOR I.V. INJ.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > DELTA PHARMA",
          "price_egp": 29.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "WINTRIAXONE 1 GM PD. FOR I.V INJ.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SANOFI",
          "price_egp": 48.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "VOTRIAXONE 1 GM I.M VIAL",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CHEMIPHARM",
          "price_egp": 56.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "OFRAMAX 1 GM I.M. VIAL",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > SUN PHARMA EGYPT LIMITED",
          "price_egp": 71.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "TRIAXONE 1 GM I.M. VIAL",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA",
          "price_egp": 106.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "TRIAXONE 1 GM I.V VIAL",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA",
          "price_egp": 106.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "facial-cellulitis-referral"
    },
    {
      "id": 721,
      "generic": "Amoxicillin + Clavulanic acid",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 875.0,
      "adult_dose": "875/125 mg orally twice daily (or 1000/200 mg IV 3 times daily) for mild, non-toxic early erysipelas without orbital signs",
      "adult_duration": "5-7 days",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (amoxicillin and clavulanate monograph)",
      "rationale": "Oral outpatient step-down or initial treatment strictly for mild, early non-orbital cases",
      "cautions": [
        "Contraindicated in penicillin allergy or history of co-amoxiclav-associated jaundice/hepatic dysfunction.",
        "Monitor for fever, visual changes, or proptosis (signals orbital cellulitis emergency)."
      ],
      "peds_mgkg_low": 25.0,
      "peds_mgkg_high": 45.0,
      "peds_max_mg": 1750.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "Child >3 months: 25-45 mg/kg/day divided BID (based on amoxicillin component)",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 250,
          "high_mg": 450,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 500,
          "high_mg": 900,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 750,
          "high_mg": 1350,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 1000,
          "high_mg": 1750,
          "capped": true
        }
      ],
      "brands": [
        {
          "trade_name": "E-MOXCLAV 1G 10 F.C. TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 14.0,
          "pack_count": 10,
          "unit_price": 1.4,
          "strength_mg": 1000.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "AUJED 625 MG 12 F.C. TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA TEC > JEDCO INT. CO. FOR PHARMACEUTICALS",
          "price_egp": 19.2,
          "pack_count": 12,
          "unit_price": 1.6,
          "strength_mg": 625.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "E-MOXCLAV 375MG 10 F.C. TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "EIPICO",
          "price_egp": 20.4,
          "pack_count": 10,
          "unit_price": 2.04,
          "strength_mg": 375.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "MAGNABIOTIC 625MG 8 TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SEDICO",
          "price_egp": 37.0,
          "pack_count": 8,
          "unit_price": 4.62,
          "strength_mg": 625.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CURAM 625MG 12 F.C.TAB.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SANDOZ > NOVARTIS",
          "price_egp": 108.0,
          "pack_count": 12,
          "unit_price": 9.0,
          "strength_mg": 625.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "AUGMENTIN 625 MG 10 F.C.TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MUP > SMITHKLINE BEECHAM",
          "price_egp": 117.0,
          "pack_count": 10,
          "unit_price": 11.7,
          "strength_mg": 625.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CLAVOCILLIN 1 GM 10 DISPERSIBLE TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "RAMEDA > ORGANOPHARMA",
          "price_egp": 106.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "AUGMENTIN ADULTS 1GM/125MG 12 PWD. ORAL SUSP. SACHETS",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 169.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": false,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "LARYNCLAVE 125/31 PD. FOR ORAL SUSP. 70ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR > AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.",
          "price_egp": 8.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "MEGACLAVOX 156MG/5ML PD. FOR SUSP. 60 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 8.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 156.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "facial-cellulitis-referral"
    },
    {
      "id": 722,
      "generic": "Cephalexin",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 500.0,
      "adult_dose": "Usual adult dosage range: Oral: 250 to 1,000 mg every 6 hours or 500 mg every 12 hours (maximum: 4 g/day).",
      "adult_duration": "5 days",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023",
      "rationale": "First-generation oral cephalosporin providing first-line spectrum against Group A Streptococcus and MSSA for mild nonpurulent cellulitis or step-down oral therapy.",
      "cautions": [
        "Hypersensitivity to cephalexin, other cephalosporins, or any component of the formulation"
      ],
      "peds_mgkg_low": 25.0,
      "peds_mgkg_high": 50.0,
      "peds_max_mg": 2000.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "Mild to moderate infection: Oral: 25 to 50 mg/kg/day divided every 6 or 12 hours; maximum daily dose: 2,000 mg/day.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 250,
          "high_mg": 500,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 500,
          "high_mg": 1000,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 750,
          "high_mg": 1500,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 1000,
          "high_mg": 2000,
          "capped": false
        }
      ],
      "brands": [
        {
          "trade_name": "CEFLODIX 500 MG 12 CAPS.",
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          "normalized_ingredient": null,
          "manufacturer": "ARAB CAPS > PHAROPHARMA",
          "price_egp": 9.0,
          "pack_count": 12,
          "unit_price": 0.75,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CEPHALEXCID 500 MG 12 CAPS.",
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          "normalized_ingredient": null,
          "manufacturer": "CID",
          "price_egp": 10.3,
          "pack_count": 12,
          "unit_price": 0.86,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
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          "also_contains": null
        },
        {
          "trade_name": "CEPHOXIN 500MG 12 TAB.",
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          "normalized_ingredient": null,
          "manufacturer": "PHARCO B",
          "price_egp": 10.5,
          "pack_count": 12,
          "unit_price": 0.88,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CEPHALEXIN 500MG 10 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "ARAB DRUG COMPANY (ADCO)",
          "price_egp": 10.1,
          "pack_count": 10,
          "unit_price": 1.01,
          "strength_mg": 500.0,
          "exact_strength": true,
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          "discontinued": false,
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        },
        {
          "trade_name": "MEDICEFLEXIN 500 MG 20 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "T3A PHARMA > RIVA PHARMA S.A.E.",
          "price_egp": 25.25,
          "pack_count": 20,
          "unit_price": 1.26,
          "strength_mg": 500.0,
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          "discontinued": false,
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        },
        {
          "trade_name": "CEPHALEXIN 500MG 12 CAPS B.P.2007",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SHIFA MEDICAL PRODUCTS > OCTOBER PHARMA",
          "price_egp": 27.0,
          "pack_count": 12,
          "unit_price": 2.25,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "KEFLEX 500 MG 12 CAPS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "HIKMA PHARMA",
          "price_egp": 58.0,
          "pack_count": 12,
          "unit_price": 4.83,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "CEPOREX 500MG 12 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "GLAXO SMITHKLINE",
          "price_egp": 69.0,
          "pack_count": 12,
          "unit_price": 5.75,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "AMTHROST 125MG/5ML SUSP. 60ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA > SABAA",
          "price_egp": 4.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 125.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "AMTHROST 250MG/5ML SUSP. 60ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "SIGMA > SABAA",
          "price_egp": 4.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 250.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "facial-cellulitis-referral"
    },
    {
      "id": 723,
      "generic": "Cefazolin",
      "line": 1,
      "is_adjunct": false,
      "form": "injection",
      "strength_mg": null,
      "adult_dose": "1 to 2 g IV every 8 hours",
      "adult_duration": "5 days",
      "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023",
      "rationale": "Parenteral first-generation cephalosporin for hospitalized patients with severe or systemic non-MRSA facial cellulitis.",
      "cautions": [
        "CONTRAINDICATED in patients with hypersensitivity reactions to cefazolin or other cephalosporins.",
        "Caution should be exercised when administering cefazolin to breastfeeding women.",
        "May be associated with elevated INR, especially in nutritionally-deficient patients, prolonged treatment, or hepatic or renal disease.",
        "Prolonged use may result in fungal or bacterial superinfection, including Clostridioides difficile-associated diarrhea (CDAD) and pseudomembranous colitis."
      ],
      "peds_mgkg_low": 25.0,
      "peds_mgkg_high": 100.0,
      "peds_max_mg": 6000.0,
      "peds_basis": "day",
      "peds_unit": "mg",
      "peds_note": "General dosing, susceptible infection: Infants, Children, and Adolescents: IM, IV: Mild to moderate infections: 25 to 100 mg/kg/day divided every 8 hours; maximum daily dose: 6 g/day.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 250,
          "high_mg": 1000,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 500,
          "high_mg": 2000,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 750,
          "high_mg": 3000,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 1000,
          "high_mg": 4000,
          "capped": false
        }
      ],
      "brands": [
        {
          "trade_name": "ZINOL 500 MG I.M./I.V. VIAL",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO B",
          "price_egp": 31.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 500.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "ZINOL 1 GM I.M./I.V. VIAL",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO B",
          "price_egp": 48.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 1000.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "facial-cellulitis-referral"
    },
    {
      "id": 724,
      "generic": "Clindamycin",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 300.0,
      "adult_dose": "300 to 450 mg six-hourly",
      "adult_duration": null,
      "dose_source": "Cellulitis - StatPearls - NCBI Bookshelf (NBK549770)",
      "rationale": "Ceftriaxone, co-amoxiclav, cephalexin and cefazolin are all beta-lactams, so a patient with a severe penicillin allergy needs something else; clindamycin covers streptococci and staphylococci including MRSA.",
      "cautions": [
        "Clindamycin carries a boxed warning for severe and sometimes fatal colitis, so it is reserved for patients who genuinely cannot have a beta-lactam.",
        "Any diarrhoea during or after the course must be taken seriously as possible Clostridioides difficile infection - tell the patient to report it rather than treat it themselves.",
        "It clears more slowly in liver disease.",
        "Facial cellulitis is a referral pathway - starting oral antibiotics does not cancel the urgent referral, and orbital or spreading disease needs intravenous treatment in hospital."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "No paediatric dose for facial cellulitis in the sources opened.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [
        {
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          "manufacturer": "SIGMA > OCTOBER PHARMA",
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          "exact_strength": true,
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          "trade_name": "ALFACLINDAMYCIN 300 MG 10 CAPS.",
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          "exact_strength": true,
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          "pack_count": 10,
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          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
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        },
        {
          "trade_name": "KLENDABIOTICAM 1 % TOP. SOLUTION",
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          "manufacturer": "PANAX PHARMA",
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        {
          "trade_name": "ADCOCLINDACE 10MG/ML TOP. SOL.",
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          "exact_strength": false,
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        }
      ],
      "condition_id": "facial-cellulitis-referral"
    },
    {
      "id": 725,
      "generic": "Sulphamethoxazole + Trimethoprim",
      "line": 1,
      "is_adjunct": true,
      "form": "oral.solid",
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      "adult_dose": "800 mg / 160 mg twice a day, given together with cephalexin 500 mg every 6 hours",
      "adult_duration": "5 days",
      "dose_source": "Cellulitis - StatPearls - NCBI Bookshelf (NBK549770)",
      "rationale": "Purulent cellulitis, an associated abscess, a puncture wound or injecting drug use all raise the chance of MRSA, and nothing else listed covers it; the combination is added to the cephalexin rather than replacing it, because on its own it covers streptococci poorly.",
      "cautions": [
        "Do not give it to anyone with a sulfonamide allergy, a past sulfonamide or trimethoprim immune thrombocytopenia, folate-deficiency megaloblastic anaemia, marked liver damage, or severe renal impairment that cannot be monitored.",
        "Avoid it in late pregnancy and in infants under 2 months.",
        "It raises the INR sharply in patients on warfarin and raises potassium, particularly alongside an ACE inhibitor or a potassium-sparing diuretic.",
        "It is added to the cephalexin, not swapped for it - on its own it is unreliable against streptococci, which cause most facial cellulitis.",
        "Facial cellulitis is an urgent referral pathway; oral treatment is for mild, early, non-orbital disease only."
      ],
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      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Contraindicated in infants under 2 months. No paediatric cellulitis dose in the sources opened.",
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      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
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      "peds_doses": null,
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          "pack_count": 20,
          "unit_price": 0.25,
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          "pack_count": 20,
          "unit_price": 1.9,
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          "exact_strength": true,
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        },
        {
          "trade_name": "SEPTAZOLE FORTE 800/160MG 20 TABS.",
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          "manufacturer": "ALEXANDRIA",
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          "strength_mg": 160.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
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        },
        {
          "trade_name": "SEPTRIN D.S 10 TABS.",
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          "manufacturer": "GLAXO SMITHKLINE > ASPEN PHARMA TRADING LIMITED",
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          "pack_count": 10,
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          "exact_strength": true,
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        },
        {
          "trade_name": "SEPTAZOLE 400/80MG 20*10 TABS.",
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          "pack_count": 10,
          "unit_price": 34.0,
          "strength_mg": 80.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SUTRIM 400/80MG 20*10 TAB.",
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          "manufacturer": "MEMPHIS",
          "price_egp": 340.0,
          "pack_count": 10,
          "unit_price": 34.0,
          "strength_mg": 80.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
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        },
        {
          "trade_name": "CO-TRIMOXAZOLE 200/40MG SUSP. 120ML",
          "scientific_name": null,
          "normalized_ingredient": null,
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          "price_egp": 6.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 40.0,
          "exact_strength": false,
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          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "SUTRIM 200/40MG SUSP. 100ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 18.5,
          "pack_count": null,
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          "strength_mg": 40.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "facial-cellulitis-referral"
    }
  ]
}