Polymicrobial skin & soft tissue, Severe Immunosuppression / Neutropenia

  • groin/peri-rectal cellulitis/Fournier’s gangrene

  • progressive diabetic wound

  • severe bite/traumatic wounds

- Recommend urgent surgical/ID consult.

 

Empiric Therapy Dose Duration
Piperacillin-tazobactam 3.375g-4.5g IV q6h 7-14 days
+    
Vancomycin 25-30mg/kg IV once then 15mg/kg IV q8-12h  

Penicillin allergy/anaphylaxis

Empiric Therapy Dose Duration
Vancomycin 25-30mg/kg IV once then 15mg/kg IV q8-12h 7-14 days
+    
Ciprofloxacin 400mg IV q12h  
+    
Metronidazole 500mg IV q12h