Original Title: Cellulite infectieuse chez l’adulte et l’enfant – Repérage, diagnostic, usage optimal des antibiotiques et mesures de prévention des complications ou récidives

Authors' objectives: In October 2017, the Institut national d’excellence en santé et en services sociaux (INESSS) published recommendations and clinical guidelines to support the diagnosis and management of cellulitis in adults and children, which were presented in two tools. Given the evolving knowledge, INESSS deemed it necessary to update its work to reflect the latest scientific data, its recent related work, and trends in best practices concerning the subject, particularly with regard to antibiotic stewardship.

Authors' results and conclusions: RESULTS (#1 CONSOLIDATE CLINICAL PRESENTATION OF CELLULITIS): In addition to retaining the four cardinal signs of cellulitis – erythema, edema, warmth and tenderness – and other specific features, the update now includes additional suggestive clues, such as the presence of a streak of lymphangitis and a temperature difference between affected and healthy areas. (#2 TREAT ACCORDING TO TREATMENT PRINCIPLES AND THE SOURCE OF THE INFECTION): Among the changes concerning the different antibiotics, cefadroxil, which is no longer recommended for pediatric use by Health Canada, has been removed from the list of treatment options for typical infectious cellulitis in children. (#3 REFER BASED ON SEVERITY, COMPLEXITY AND AREAS OF EXPERTISE): The update takes into account the recent changes in the healthcare system. In addition to improvements to the warning signs that warrant referring a patient to emergency services, the clinical situations calling for a consultation with an experienced colleague, a physician from another medical specialty, or a dental specialist have been enhanced. These include, among others, complex cases and suspected uncertain etiology. CONCLUSION: While not intended as a substitute for clinical judgment, this update and the ensuing recommendations will promote harmonized practice across the province by reducing treatment durations and offering a wider range of antibiotics for patients with penicillin allergies.

Authors' methods: A structured literature search across three bibliographic databases, supplemented by a manual search of the grey literature, was conducted to update the systematic review of clinical practice guides, guidelines, and health technology assessment reports that was carried out in 2017. Items published in French and English from 2020 to 2025 were targeted. A monitoring of emerging scientific literature was conducted up to May 2026.

Project Status: Completed

Year Published: 2026

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/cellulite-infectieuse.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)