Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Necrotizing SSTIs

Management

Emergent surgical debridement

ID Consultation recommended

Initial Empiric Treatment

Linezolid

AND

Piperacillin/Tazobactam (Zosyn®)

See below for alternative

Alternative to Pip-Tazo

Use the following two drugs in place of Piperacillin/Tazobactam (Zosyn®) if:

  • Unknown β-lactam allergy

  • Known allergy to piperacillin/tazobactam

  • Water exposure

Ciprofloxacin

AND

Metronidazole

Definitive Therapy

Beta hemolytic streptococci or clostridial sp.

MRSA or MSSA

Aeromonas hydrophilia

Vibrio vulnificus

Duration

Duration of treatment and transition to PO therapy will be determined based on clinical course