Necrotizing Infection ABx

Notes

Consider IVIG, in consultation with ID.

Droplet / Contact Precautions

Risk of invasive group A streptococcus. Contact/droplet precautions for 24h after initiation of appropriate therapy.

Prophylaxis of contacts may be required if confirmed iGAS - notify MOH

Surgical emergency - obtain surgical consultation

Specific therapy and duration should be guided with input from the Infectious Disease service.

Vancomycin 25-30mg/kg IV load (max 2g) followed by 15mg/kg IV q12h maintenance for a target trough of 15-20µg/mL

Vancomycin may be discontinued if the culture does not recover S. aureus

AND

Clindamycin 600-900 mg IV q8h

AND EITHER

Piperacillin/Tazobactam 4.5 g IV q6-8h

OR

Meropenem 1g IV q8h

Vancomycin 25-30mg/kg IV load (max 2g) followed by 15mg/kg IV q12h maintenance for a target trough of 15-20µg/mL

Vancomycin may be discontinued if the culture does not recover S. aureus

AND

Ciprofloxacin 400 mg IV q8-12h

AND

Metronidazole 500 mg IV q8h

AND

Clindamycin 600-900 mg IV q8h