Necrotizing fasciitis/myositis in Paediatrics

- Use of IV immune globulin (1g/kg/day x 2 days) could be considered if streptococcal toxic shock also present.

- Invasive Group A Streptococci is reportable to Public Health.

- Prophylaxis of contacts of invasive Group A Streptococci is recommended by most Public Health experts. See Prophylaxis for Contacts of Communicable Diseases.

Therapy	Dose	Duration
Penicillin	300,000 units/kg/d IV div q4h	minimum 10 days
+
Clindamycin	40mg/kg/d IV div q8h	Continue until hemodynamically stable and initial debridement complete (1-3 days)

Therapy	Dose	Duration
Penicillin	300,000 units/kg/d IV div q4h	minimum 10 days
+
Clindamycin	40mg/kg/d IV div q8h	Continue until hemodynamically stable and initial debridement complete (1-3 days)

Therapy	Dose	Duration
Ceftriaxone	100mg/kg IV q24h	minimum 10 days
+
Clindamycin	40mg/kg/d IV div q8h	Continue until hemodynamically stable and initial debridement complete (1-3 days)

Therapy	Dose	Duration
Cloxacillin	200mg/kg/d IV div q4h	minimum 10 days
+
Clindamycin	40mg/kg/d IV div q8h	Continue until hemodynamically stable and initial debridement complete (1-3 days)

Therapy	Dose	Duration
Vancomycin	60mg/kg/d IV div q6h	minimum 10 days