Spectrum: Local Antimicrobial Stewardship, for Bakersfield Memorial Hospital

Necrotizing Fasciitis

Consults

Urgent surgical consult is indicated

Treatment

Vancomycin

PLUS EITHER

Ceftriaxone

AND

Metronidazole

OR

Cefepime

AND

Metrinidazole

OR

Piperacillin-Tazobactam

Other Considerations

Add clindamycin for suspected group A streptococci

No proven advantage of adding IVIG

Duration of Therapy

Treat until all of the following:

  • Debridement no longer necessary

  • Improved clinically

  • Fever absent for 48-72 hours