Necrotising Fasciitis

First Line

Benzylpenicillin 2.4 g IV 6 hourly AND Flucloxacillin 2g IV 6 hourly AND Clindamycin 1.2g IV 6 hourly AND Metronidazole 500mg IV 8 hourly AND Gentamicin IV as per protocol

Penicillin Allergy (or MRSA positive)

Vancomycin IV as per protocol AND Clindamycin 1.2g IV 6 hourly AND Metronidazole 500mg IV 8 hourly AND Gentamicin IV as per protocol

Notes

Characterised by pain disproportionate to clinical findings, rapidly spreading infection, dusky skin

SEEK URGENT SURGICAL REVIEW

Second line treatment based on advice from microbiology.

If evidence of toxic shock - consider IVIG