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Erysipelas is defined as non\u2010purulent infection considered to be caused by beta\u2010hemolytic strepto\u00adcocci. It is diagnosed clinically by its bright\u2010red erythema and early fever or chills at disease onset. Penicillin is the treatment of choice. Limited soft tissue infection (cellulitis) is usually caused by <jats:italic>Staphylococcus (S.) aureus,<\/jats:italic> frequently originates from chronic wounds and presents with a more violaceous\u2010red hue and only rarely with initial fever or chills. Treatment consists of first\u2010 or second\u2010\u00adgeneration cephalosporins or flucloxacillin (IV).<\/jats:p><jats:p>Severe cellulitis is a purulent, partially necrotic infection which extends through tissue boundaries to fascias and requires surgical management in addition to antibiotics. Moreover, it frequently fulfills the criteria for \u201ccomplicated soft tissue infections\u201d, as previously defined by the Food and Drug Administration for use in clinical trials (they include comorbidities such as uncontrolled diabetes, peripheral artery disease, neutropenia). It requires antibiotics which besides <jats:italic>S. aureus<\/jats:italic> target anaerobic and\/or gramnegative bacteria. The rare so\u2010called necrotizing skin and soft tissue infections represent a distinct entity. They are characterized by rapid, life\u2010threatening progression due to special bacterial toxins that cause ischemic necrosis and shock and need rapid and thorough debridement in addition to appropriate antibiotics. For cutaneous abscesses the first\u2010line treatment is adequate drainage. Additional antibiotic therapy is required only under certain circumstances (e.g., involvement of the face, hands, or anogenital region, or if drainage is somehow complicated).<\/jats:p><jats:p>The present guidelines also contain consensus\u2010based recommendations for higher doses of antibiotics than those approved or usually given in clinical trials. The goal is to deliver rational antibiotic treatment that is both effective and well\u2010tolerated and that exerts no unnecessary selection pressure in terms of multidrug resistance.<\/jats:p>","DOI":"10.1111\/ddg.13790","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T14:45:44Z","timestamp":1553784344000},"page":"345-369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["S2k guidelines for skin and soft tissue infections Excerpts from the S2k guidelines for \u201ccalculated initial parenteral treatment of bacterial infections in adults \u2013 update 2018\u201c"],"prefix":"10.1111","volume":"17","author":[{"given":"Cord","family":"Sunderk\u00f6tter","sequence":"first","affiliation":[{"name":"Department of Translational Dermatoinfectiology Medical Faculty of the University of M\u00fcnster, and Department of Dermatology and Venereology, University Medical Center Martin Luther University of Halle\u2010Wittenberg  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Becker","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology M\u00fcnster University Medical Center  M\u00fcnster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Eckmann","sequence":"additional","affiliation":[{"name":"Department of General Visceral and Thoracic Surgery Peine Medical Center  Peine Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Graninger","sequence":"additional","affiliation":[{"name":"Medical University of Vienna, Department of Internal Medicine\u00a0I Division of Infectious Diseases and Tropical Medicine Vienna General Hospital  Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kujath","sequence":"additional","affiliation":[{"name":"Department of Visceral Vascular and Thoracic Surgery Heide Medical Center  Heide Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Sch\u00f6fer","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Allergology University hospital Frankfurt Goethe\u2010university  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ddg.12909"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-8579(03)00154-7"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800770309"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/520743"},{"key":"e_1_2_3_6_1","unstructured":"US Food and Drug Administration CfDEa Research.Guidance for Industry Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment. 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