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

No Necrotizing Process

Initial Empiric Treatment

Vancomycin IV

AND

Cefepime IV

OR

Vancomycin IV

AND

Levofloxacin IV

If allergy to cefepime

IF TOXIC SHOCK SYNDROME, ADD

Clindamycin IV

Until clinical improvement. Clindamycin added for toxin mediated effect for GAS

De-Escalation

May switch to PO if tolerating PO, afebrile, and signs of skin infection improving

Once susceptibilities are available, de-escalate to narrowest spectrum PO antibiotic

Duration

Without TSS
7 Days

With TSS
14 days