Published
Bacterial skin and soft tissue infections — diagnosis and antibiotic prescribing ACG
Condition
Dermatology
Infectious diseases
Guidance type
ACG
21 September 2026
Published on 21 September 2026
This ACE Clinical Guideline (ACG) covers the diagnosis, assessment, and management of bacterial skin and soft tissue infections (SSTIs), with guidance provided especially for those providing primary or generalist care. The ACG offers evidence-based recommendations on the clinical diagnosis of bacterial SSTIs based on history taking and physical examination findings, as well as guidance on severity assessment and antibiotic prescribing. Two supplements are included: a guide on differential diagnoses for bacterial SSTIs and an antibiotic dosing table to facilitate the translation of the ACG recommendations into clinical practice.
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Bacterial skin and soft tissue infections — diagnosis and antibiotic prescribing (pending publication) [WEB]
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ACG recommendations
Diagnose bacterial SSTIs clinically, based on history taking and physical examination findings.
Assess the severity of infection and risk of complications to determine the management approach, including referral urgency.
For patients with impetigo or bacterial folliculitis:
Prescribe topical antibiotic monotherapy for localised mild infections.
Prescribe oral antibiotic monotherapy for severe infections.
For patients with bacterial furuncles, carbuncles, or skin abscess:
Consider surgical intervention based on clinical presentation, and
Reserve oral antibiotic monotherapy for severe infections.
For patients with bacterial cellulitis or erysipelas:
Prescribe oral antibiotic monotherapy for mild infections.
Reserve intravenous antibiotic monotherapy for severe infections.
ACG supplementary guides
ACG references and Expert Group details
SSTI ACG references (Sep 2026) [PDF, 162.69 KB] (opens in new tab)
SSTI ACG EG composition and other details (Sep 2026) [PDF, 109.15 KB] (opens in new tab)
ACG EtR framework
The Evidence-to-Recommendation (EtR) framework is a document that outlines the underpinning evidence and rationale for the recommendations in our ACGs. Download the EtR framework below to learn more about factors that have informed the strength of the ACG recommendations, including certainty of evidence, clinical benefit/risk balance, local resource implications, feasibility considerations, patient preferences and values, acceptability and other considerations.
SSTI EtR framework with summary of findings (Sep 2026) [PDF, 477.62 KB] (opens in new tab)
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