Necrotising Fasciitis / Fournier's gangrene

First Line

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

Penicillin Allergy (or MRSA positive)

Vancomycin IV as per protocol  AND Clindamycin 1.2g  IV 6 hrly AND Metronidazole 500mg IV 8 hrly 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.