Page 46 - HPP ANTIMICROBIAL GUIDELINE 2018

Suggested Treatment
Infection/ Condition Comments
Preferred Alternative

Necrotizing Fasciitis

Severe Piperacillin/tazobactam 4.5gm
IV q8h Immediate surgical debridement is
the primary treatment modality
PLUS/MINUS
Clindamycin 600-900mg IV q8h Repeated surgical debridement for
source control is needed

Antibiotic should be streamlined
Mild to moderate Ampicillin/sulbactam 1.5–3gm based on intraoperative culture and
IV q6h (inpatient) sensitivity

PLUS/MINUS Consider adding clindamycin if risk of
Clindamycin 600-900mg IV q8h Group A streptococcus or presence
of gas crepitus

Marine related Duration of treatment 7-14 days
Vibrio vulnificus Ceftriaxone 1 gm IV q12hr depending on clinical response
Aeromonas hydrophilia
-consider in water related injuries and PLUS
patients with liver cirrhosis and ingestion of Doxycycline 100mg PO q12hrly
raw shellfish

HPP AMG Bone & Joints Infections 18