infectious

Cellulitis and erysipelas

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 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 against4 documents

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)

Verified date2026-08

Presentation reference

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

SourceStatPearls "Cellulitis" - disease-level clinical article

Presentation findings are traced to the source above.

CEFALEXIN

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

500 mg QID (every 6 hours) or 1 g BID x 5-7 days

Paediatric dose

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))

Dose by weight
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.

Dose source

IDSA Practice Guidelines for Skin and Soft Tissue Infections 2014

Why

First-line oral beta-lactam for non-purulent skin infection

Cautions

Use with caution in severe penicillin hypersensitivity (cross-reactivity risk).
Reduce dosage in severe renal impairment (eGFR < 30).
Monitor for Clostridioides difficile diarrhea.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
CEFLODIX 500 MG 12 CAPS.	ARAB CAPS > PHAROPHARMA	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 COMPANY (ADCO)	10.10 EGP (1.01/unit)
MEDICEFLEXIN 500 MG 20 CAPS.	T3A PHARMA > RIVA PHARMA S.A.E.	25.25 EGP (1.26/unit)
CEPHALEXIN 500MG 12 CAPS B.P.2007	SHIFA MEDICAL PRODUCTS > OCTOBER PHARMA	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? strength differs? different route - not oral solid	SIGMA > SABAA	4.00 EGP
AMTHROST 250MG/5ML SUSP. 60ML? strength differs? different route - not oral solid	SIGMA > SABAA	4.50 EGP

CEFADROXIL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

500 mg to 1 g BID (every 12 hours) x 5-7 days

Paediatric dose

30-50 mg/kg/day [child max 2000 mg]

(Given in 1-2 divided doses daily)

Dose by weight
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)

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023 (cefadroxil monograph)

Why

Convenient twice-daily dosing alternative to cephalexin

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
MEGADROXIL 500 MG 8 CAPS.	SHIFA MEDICAL PRODUCTS > MASH PREMIERE	4.50 EGP (0.56/unit)
CEFADROXIL 500MG 8 CAPS.	SIGMA	7.50 EGP (0.94/unit)
DURABIOTIC 500MG 8 CAPS.	LOGESTIC PHARMA FOR PHARMACEUTICALS	9.00 EGP (1.12/unit)
BIODROXIL 500MG 8 CAPS.	KAHIRA > NOVARTIS	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 BEECHAM	72.00 EGP (6.00/unit)
LONGICEF 125MG/5ML SUSP. 60 ML? strength differs? different route - not oral solid	KAHIRA	4.25 EGP
CEFADROXIL 250MG/5ML PD. FOR ORAL SUSP. 60ML? strength differs? different route - not oral solid	SIGMA	7.50 EGP

CEPHRADINE

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

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

Paediatric dose

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.)

Dose by weight
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

Dose 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.

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
CEFADRIN 500MG 12CAPS.	UP PHARMA	11.00 EGP (0.92/unit)
VELOSEF 500MG 16 CAPS.	SMITHKLINE BEECHAM > GLAXO SMITHKLINE	118.00 EGP (7.38/unit)
MEPADRIN 125MG/5ML GR. FOR ORAL 60ML SUSP.? strength differs? different route - not oral solid	CHEMIPHARM	7.00 EGP
CEFADRINE 125MG/5ML 60ML SUSP.? strength differs? different route - not oral solid	UP PHARMA	7.50 EGP

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line

Dose 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.

Cautions

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.

AMOXICILLIN

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

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

Paediatric dose

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).)

Dose by weight
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)

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

First-line oral aminopenicillin for mild erysipelas.

Cautions

Serious hypersensitivity to amoxicillin or to other beta-lactams, or any component of the formulation.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
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 > SMITHKLINE BEECHAM	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? strength differs? different route - not oral solid	EL NASR	3.00 EGP
AMOXIL FORT 250MG/5ML SUSP. 60ML? strength differs? different route - not oral solid	MUP > SMITHKLINE BEECHAM	5.50 EGP

CLINDAMYCIN

2nd line

Strength300 mg

Formoral.solid

Adult dose and duration

300–450 mg every 6 hours

Paediatric dose

8-20 mg/kg/day

(Children (oral, capsule): 8 to 20 mg/kg/day divided every 6 to 8 hours.)

Dose by weight
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.

Dose source

Egyptian National Drug Formulary - Antimicrobial 2023

Why

Alternative oral lincosamide antibiotic for non-purulent cellulitis in patients with severe beta-lactam allergy.

Cautions

Hypersensitivity to clindamycin, lincomycin, or any component of the formulation.
Potential to cause Clostridioides difficile-associated diarrhea.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
ADCOCLINDACE 300 MG 16 CAPS.	ARAB DRUG COMPANY (ADCO)	24.00 EGP (1.50/unit)
CLINACYN 300MG 16 CAPS.	SIGMA > EGYPTIAN PHARMACISTS COMPANY	31.50 EGP (1.97/unit)
CLINDAM 300 MG 16 CAPS.	SIGMA > OCTOBER PHARMA	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 PHARMA	76.00 EGP (6.33/unit)
ALFACLINDAMYCIN 300 MG 10 CAPS.	ATCO PHARMA > ROTABIOGEN	69.00 EGP (6.90/unit)
DALACIN C 300MG 10 CAPS.	PFIZER	114.00 EGP (11.40/unit)
KLENDABIOTICAM 1 % TOP. SOLUTION? strength differs? different route - not oral solid	PANAX PHARMA	8.50 EGP
ADCOCLINDACE 10MG/ML TOP. SOL.? strength differs? different route - not oral solid	ARAB DRUG COMPANY (ADCO)	12.00 EGP

CO-TRIMOXAZOLE

2nd line

Formoral.solid

Adult dose and duration

800 mg/160 mg twice daily x 5 days

Paediatric dose

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.)

Dose by weight
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)

Dose 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.

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
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 SMITHKLINE > ASPEN PHARMA TRADING LIMITED	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? strength differs? different route - not oral solid	MUP	6.00 EGP
SUTRIM 200/40MG SUSP. 100ML? strength differs? different route - not oral solid	MEMPHIS	18.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.