ما هو علاج التهاب اللفافة النخري؟

References

DOI: 10.1093/cid/ciu296

• Prompt surgical consultation is recommended for patients with aggressive infections associated with signs of systemic toxicity or suspicion of necrotizing fasciitis or gas gangrene (severe nonpurulent; Figure 1) (strong, low).
• Empiric antibiotic treatment should be broad (eg, vancomycin or linezolid plus piperacillin-tazobactam or plus a carbapenem, or plus ceftriaxone and metronidazole), as the etiology can be polymicrobial (mixed aerobic-anaerobic microbes) or monomicrobial (group A Streptococcus, community-acquired MRSA) (strong, low).
• Surgical intervention is the primary therapeutic modality in cases of necrotizing fasciitis and is indicated when this infection is confirmed or suspected.
• Empiric treatment of polymicrobial necrotizing fasciitis should include agents effective against both aerobes, including MRSA, and anaerobes.
• In the absence of definitive clinical trials, antimicrobial therapy should be administered until further debridement is no longer necessary, the patient has improved clinically, and fever has been absent for 48–72 hours.