Page 47 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 47

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
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