How should I manage a patient presenting with a suspected secondary infection following an insect bite?

For a patient presenting with a suspected secondary infection following an insect bite, treat cellulitis in primary care with oral antibiotics according to local prescribing protocols.

Consider the need for hospital admission if cellulitis is severe or worsening despite primary care management.

Arrange follow-up to ensure resolution of symptoms.

Advise the patient on good hygiene and avoidance of itching to prevent further secondary infection.

If the patient reports severe pain disproportionate to the wound appearance, or systemic symptoms such as fever, reassess promptly as this may indicate toxin-producing bacteria.

Do not prescribe corticosteroids if infection is suspected.

For analgesia, oral paracetamol or ibuprofen may be used to ease pain, although evidence is limited.

In cases where the bite is complicated by infestation (e.g., bedbugs, fleas, lice, scabies), advise appropriate pest control or treatment of animals as relevant.