Fasciitis Necroticans after Elective Hernia Inguinal Surgery

Table 1

Foundation working party on antibiotic policy necrotizing fasciitis.

Type	Advice
Unknown pathogen	(i) Penicillin 2 Million E	6 dd iv +
	(ii) clindamycin 600 mg	3 dd iv +
	(iii) with aminoglycoside	1 dd iv
	or
	(iv) clindamycin 600 mg	3 dd iv +
	(v) aminoglycoside	1 dd iv
	or
	(vi) penicillin 2 milj E	6 dd iv +
	(vii) clindamycin 600 mg	3 dd iv +
	(viii) ciprofloxacin 400 mg	2-3 dd iv
Type 1: aerobe and anaerobe mixed flora	(i) Amoxicillin 1000 mg	4 dd iv
	(ii) aminoglycoside	1 dd iv +
	(iii) metronidazole 500 mg	3 dd iv
	or
	(iv) amoxicillin-clavulanic; acid 1000/200 mg	6 dd
	(v) clindamycin 600 mg	3 dd iv of oral
	(vi) with aminoglycoside
	or
	(vii) cefuroxime 750–1500 mg	3 dd iv
	(viii) metronidazole 500 mg	3 dd iv +
	(ix) aminoglycoside	1 dd iv once
Type 2: GAS	(i) Penicillin 1 tot 2 milj E	6 dd iv +
	(ii) clindamycin 600 mg	3 dd iv
	or in allergy for beta-lactam:
	(a) cefuroxime 750–1500 mg	3 dd
	(b) or cefotaxime 1000 mg	4 dd
	(c) or ceftriaxone 2000 mg	1 dd iv +
	(ii) clindamycin 600 mg	3 dd iv

GAS: Group A beta-haemolytic streptococ; dd: de die, per day; iv: intravenous.