Necrotizing Fasciitis

Note

Early and aggressive surgical debridement of all necrotic tissue is essential.

  • Rapid progression
  • Pain out of proportion
  • Systemic signs of sepsis and organ dysfunction
  • Signs of deeper infection (skin sloughing, bullae)
  • Profound systemic toxicity
  • Advancement of infection during antibiotic therapy
  • Skin necrosis
  • Presence of gas

Empiric Regimen of Choice

Treat as severe, non-purulent SSTI until C&S confirmation

Definitive Regimen for proven Group A Streptococci

AND

Duration of Therapy

Intravenous treatment until further debridement no longer necessary and has improved clinically and fever has been absent for 48–72 hours.

Stepdown and total duration of therapy based on clinical progression.