Necrotizing Infection ABx

Notes

Consider IVIG, in consultation with Infectious Diseases.

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

Medical therapy should be guided by the Infectious Diseases service.

Vancomycin IV loading dose followed by maintenance for target trough of 15-20 ug/mL
see dosing nomogram

If patient cannot be dosed using nomogram
contact Pharmacy.

Vancomycin may be discontinued if the culture does not grow 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 IV loading dose followed by maintenance for target trough of 15-20 ug/mL
see dosing nomogram

If patient cannot be dosed using nomogram
contact Pharmacy.

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

AND

Ciprofloxacin 400 mg IV q8-12h

AND

Metronidazole 500 mg IV q8h

AND

Clindamycin 600-900 mg IV q8h