Adult
Necrotising Fasciitis
- Necrotising fasciitis is an emergency and requires prompt treatment with effective antimicrobials and urgent referral to plastic surgery team
- Consult Micro/ID urgently. All patients should be re-reviewed by Micro/ID 48 hours after the start of therapy.
- Cases should be discussed with ICU (intensive care unit)
- IVIg may be indicated. This must be approved by Micro/ID.
Preferred
co-amoxiclav 1.2g iv tds AND clindamycin 900mg iv qds
For MRSA positive patients: ADD vancomycin iv
Alternative
For penicillin allergy (non-severe)
ceftriaxone 2g iv od AND clindamycin 900mg iv qds
For MRSA positive patients: ADD vancomycin iv
For penicillin allergy (severe)
ciprofloxacin* 400mg iv bd
AND clindamycin 900mg iv qds
AND vancomycin iv
*Ensure that the patient is given the Fluoroquinolone MHRA patient information leaflet.
Fluoroquinolones, including ciprofloxacin, are associated with disabling and potentially long-lasting or irreversible side effects. See Fluoroquinolone antibiotics - severe adverse effects.