Duration of Therapy in Necrotizing Fasciitis

presented with necrotizing fasciitis from Streptococcus pyogenes. After 3 debridements, no further surgery is planned. He is afebrile x 48 hours after his last surgery and improving

He is on penicillin + clindamycin.

What is the BEST antibiotic plan?

A. No change
B. Stop clindamycin
C. Stop penicillin
D. Stop both

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Best Answer

Stop both 🛑🛑

Explanation: IDSA guidelines recommend stopping antibiotics 48 hours after the LAST surgical debridement if a patient is:
-clinically improved 👍
-afebrile >/=48 hours

Multiple studies showed NO DIFFERENCE in clinical failure or mortality when antibiotics were stopped at 48 hours after last surgery vs continued longer.