Guidelines
Necrotising Fasciitis (Unknown Etiology)

Necrotising Fasciitis (Unknown Etiology)

Most Likely Pathogens (May be Polymicrobial)

Consults

PICU, ID, Surgery, and/or relevant subspecialty team(s) if required

Clinical Considerations

Assess need for emergent surgical source control with debridement of the affected area.

Before starting antimicrobial therapy, take blood/urine/CSF and/or other relevant samples for culture wherever possible.

Consider the need for dose adjustments (e.g. renal impairment) and age-related contraindications for antimicrobials.

First Choice

PLUS

+/-

As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

Penicillin Allergy

PLUS

+/-

As anti-MRSA agent (current local MRSA rates are available via the hospital antibiogram)

Review Daily

Adjust treatment according to microbiologic results as soon as they become available.

Additional Information

The following factors have been associated with MRSA in previous studies:

  • Previous known MRSA infection in child or a significant contact (e.g. family member)
  • Family member is a healthcare worker
  • First nations child or Pacific Island origin (e.g. Samoan)
  • Day care attendance
  • Prolonged hospitalization in the last 1 year
  • Antibiotic therapy in the last 2 months
  • Critically ill
  • Chronic skin condition (e.g. atopic eczema)