Non-Purulent - Severe

Consult

Emergent surgical inspection/debridement
Rule out necrotizing process

Preferred Empiric Treatment

Vancomycin 15-20 mg/kg q8-12h

PLUS

Piperacillin-tazobactam 3.375 g IV q8h (Extended infusion)

OR

Vancomycin 15-20 mg/kg q8-12h

PLUS

Metronidazole 500 mg IV/PO q8h

PLUS

Cefepime 1-2 g IV q8-12h

CONSIDER ADDING

Clindamycin 900 mg IV q8h

For necrotizing infection

Follow Up

Following culture and sensitivity results, target treatment based on pathogen as below for necrotizing infections.