GuidelineCurrent

IDSA NSTI 2014 — Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections

Infectious Diseases Society of America, 2014

IDSA recommends prompt surgical consultation when necrotizing fasciitis or gas gangrene is suspected. Empiric therapy should be broad (for example, vancomycin or linezolid plus piperacillin-tazobactam or a carbapenem, or plus ceftriaxone and metronidazole). Penicillin plus clindamycin is recommended for documented group A streptococcal necrotizing fasciitis; penicillin plus clindamycin is also definitive therapy for clostridial myonecrosis.

Strong recommendationLow certainty

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Clinical Context & Relevant Topics (1)

Disease Reference

Necrotizing Soft Tissue Infections (NSTI)

A surgical source-control emergency: recognize rapidly progressive deep infection, involve surgery immediately, start broad antimicrobials, resuscitate shock, and re-explore until source control is complete.

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