In the treatment of cellulitis, what is the recommended therapy for mild disease?

• A. IV antibiotics
• B. Oral antibiotics for mild disease
• C. Topical antifungals
• D. Observation only

Answer: (B)

Mild cellulitis is treated with oral antibiotics in the outpatient setting. When the infection is superficial and there are no systemic signs (fever, tachycardia, spreading infection, or severe comorbidity), oral therapy effectively covers the common skin bacteria—typically streptococci and Staphylococcus aureus. Agents like cephalexin or dicloxacillin are commonly used because they reach good tissue levels and address the usual pathogens. If there’s a higher risk for MRSA (for example, purulent drainage, recent MRSA exposure, or local prevalence), an antibiotic with MRSA activity such as doxycycline or TMP-SMX can be added or chosen instead. Topical antifungals don’t treat bacterial cellulitis, and observation alone isn’t appropriate because an active bacterial infection is present. Intravenous antibiotics are reserved for more severe disease with systemic illness or if the patient cannot take oral meds.