Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Necrotising Fasciitis

Preferred Empiric Treatment

Surgical Debridement

PLUS

Piperacillin-Tazobactam

AND

Vancomycin

AND

Clindamycin

Alternate Empiric Treatment

Cefepime

OR

Ciprofloxacin

TO EITHER OF THE ABOVE, ADD

Metronidazole

AND

Vancomycin

AND

Clindamycin

Common Organisms

S. pyogenes

S. aureus

V. vulnifixus

A. hydrophila

Anaerobic Streptococci

Polymicrobial

Including Gram-negative rods and anaerobes