Figure 3. Necrotizing Skin and Soft Tissue Infections Debridement (1C)
Antibiotics AND
Empiric
gram-negativeand gram-positive pathogens (1C)
Cover aerobic and anaerobic
ticarcillin/clavulanate acid, tigecycline, minocycline (2C)
Imipenem/cilastatin, meropenem, ertapenem, piperacillin/tazobactam,
Specific
Clostridium spp. S. pyogenes
TSS
V. vulnificans or Aermonas spp.
CWAA + PSIA (doxycline or minocycline) (1C)
Combination therapy with
Figure 4. Staphylococcus aureus – MSSA & MRSA* Complicated Infections
Simple abscess I & D I & D
Complex with substantial cellulitis
+
minocycline or tigecycline (1A)
quinupristin/ dalfopristin,
Daptomycin, linezolid,
* HA-MRSA and CA-MRSA sensitivities differ. No studies are available to establish firm guidelines (2C).
CWAA + PSIA (1C)
Combination therapy with
Toxic Shock Syndrome (TSS)
Early empiric treatment based on likelihood of MRSA (1C)
Antibiotics Consider PSIA (1C)
