Wet gangrene - Revision history

Rossdonaldson1: /* Antibiotics */

2025-05-21T19:49:52Z

Antibiotics

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 **Substitute [[linezolid]] for [[MRSA]] coverage
 **Substitute [[penicillin G]] for anaerobic coverage.
 ==Disposition==

2025-05-21T19:49:13Z

Antibiotics

← Older revision		Revision as of 19:49, 21 May 2025
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	''Initial use broad spectrum antibiotic coverage, as these are often polymycrobial infections.''		''Initial use broad spectrum antibiotic coverage, as these are often polymycrobial infections.''
	*Example 1:		*Example 1:
	**[[~~Ceftriaxone~~]] 1g IV q24h [infuse first] +		**[[Cefepime]] 1g IV q24h [infuse first] +
	**[[Vancomycin]] 1g IV or per pharmacy +
	**[[Metronidazole]] 500mg IV q8h +		**[[Metronidazole]] 500mg IV q8h +
			**[[Vancomycin]] 1g IV (or per pharmacy) +
	**Consider additionally: [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])		**Consider additionally: [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])
			*Example 2 (possible substitutions):
			**Substitute [[piperacillin-tazobactam]] OR [[meropenem]] for broad-spectrum coverage
			**Substitute [[linezolid]] for [[MRSA]] coverage
			**Substitute [[penicillin G]] for anaerobic coverage.

	{\| class="wikitable"		{\| class="wikitable"
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	\|-		\|-
	\| Anaerobic/gas gangrene \|\| Penicillin G + clindamycin		\| Anaerobic/gas gangrene \|\| Penicillin G + clindamycin
	\|-
	~~\| Polymicrobial (common in diabetics) \|\| Carbapenem monotherapy or combo therapy (e.g., ceftriaxone + metronidazole + vancomycin)~~
	\|}		\|}

2025-05-21T19:43:09Z

Antibiotics

← Older revision		Revision as of 19:43, 21 May 2025
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	*Example 1:		*Example 1:
	**[[Ceftriaxone]] 1g IV q24h [infuse first] +		**[[Ceftriaxone]] 1g IV q24h [infuse first] +
	**[[~~vancomycin~~]] 1g IV or per pharmacy +		**[[Vancomycin]] 1g IV or per pharmacy +
	**[[Metronidazole]] 500mg IV q8h +		**[[Metronidazole]] 500mg IV q8h +
	**Consider additionally: [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])		**Consider additionally: [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])

2025-05-21T19:42:11Z

Antibiotics

← Older revision		Revision as of 19:42, 21 May 2025
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	**[[vancomycin]] 1g IV or per pharmacy +		**[[vancomycin]] 1g IV or per pharmacy +
	**[[Metronidazole]] 500mg IV q8h +		**[[Metronidazole]] 500mg IV q8h +
	**Consider additionally [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])		**Consider additionally: [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])

	{\| class="wikitable"		{\| class="wikitable"

2025-05-21T19:40:50Z

Antibiotics

← Older revision		Revision as of 19:40, 21 May 2025
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	*Example 1:		*Example 1:
	**[[Ceftriaxone]] 1g IV q24h [infuse first] +		**[[Ceftriaxone]] 1g IV q24h [infuse first] +
	*[[vancomycin]] 1g IV or per pharmacy +		**[[vancomycin]] 1g IV or per pharmacy +
	*[[Metronidazole]] 500mg IV q8h +		**[[Metronidazole]] 500mg IV q8h +
	*Consider additionally [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])		**Consider additionally [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])

	{\| class="wikitable"		{\| class="wikitable"

2025-05-21T19:40:33Z

Antibiotics

← Older revision		Revision as of 19:40, 21 May 2025
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	===Antibiotics===		===Antibiotics===
	''~~Requires~~ broad spectrum antibiotic coverage, as these are often polymycrobial infections.''		''Initial use broad spectrum antibiotic coverage, as these are often polymycrobial infections.''
			*Example 1:
	~~<br>Examples~~:		**[[Ceftriaxone]] 1g IV q24h [infuse first] +
	*[[Ceftriaxone]] 1g IV q24h [infuse first] + [[vancomycin]] 1g IV or per pharmacy + [[~~metronidazole~~]] 500mg IV q8h (+ [[clindamycin]] 900mg IV q8h if suspect [[streptococcal toxic shock syndrome]])		*[[vancomycin]] 1g IV or per pharmacy +
			*[[Metronidazole]] 500mg IV q8h +
			*Consider additionally [[clindamycin]] 900mg IV q8h (if suspect anerobic/gas gangrene/[[streptococcal toxic shock syndrome]])

	{\| class="wikitable"		{\| class="wikitable"

2025-05-21T19:31:32Z

Antibiotics

← Older revision		Revision as of 19:31, 21 May 2025
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	===Antibiotics===		===Antibiotics===
	''Requires broad spectrum antibiotic coverage, as these are often polymycrobial infections.''		''Requires broad spectrum antibiotic coverage, as these are often polymycrobial infections.''
	Examples:
			<br>Examples:
	*[[Ceftriaxone]] 1g IV q24h [infuse first] + [[vancomycin]] 1g IV or per pharmacy + [[metronidazole]] 500mg IV q8h (+ [[clindamycin]] 900mg IV q8h if suspect [[streptococcal toxic shock syndrome]])		*[[Ceftriaxone]] 1g IV q24h [infuse first] + [[vancomycin]] 1g IV or per pharmacy + [[metronidazole]] 500mg IV q8h (+ [[clindamycin]] 900mg IV q8h if suspect [[streptococcal toxic shock syndrome]])

2025-05-21T19:31:09Z

Management

← Older revision		Revision as of 19:31, 21 May 2025
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	==Management==		==Management==
	* Wet gangrene requires broad spectrum antibiotic coverage, as these are often polymycrobial infections.
	* Requires surgical consultation as rapid debridement or amputation of necrotic tissue is required to prevent further spread of infection.		* Requires surgical consultation as rapid debridement or amputation of necrotic tissue is required to prevent further spread of infection.

			===Antibiotics===
			''Requires broad spectrum antibiotic coverage, as these are often polymycrobial infections.''
			Examples:
			*[[Ceftriaxone]] 1g IV q24h [infuse first] + [[vancomycin]] 1g IV or per pharmacy + [[metronidazole]] 500mg IV q8h (+ [[clindamycin]] 900mg IV q8h if suspect [[streptococcal toxic shock syndrome]])

	{\| class="wikitable"		{\| class="wikitable"

2025-05-21T18:41:23Z

Clinical Features

← Older revision		Revision as of 18:41, 21 May 2025
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	==Clinical Features==		==Clinical Features==
	[[File:DMgas gangrene.jpg\|thumb\|Wet gangrene with presumed gas.]]		[[File:DMgas gangrene.jpg\|thumb\|Wet gangrene with presumed gas.]]
			[[File:Nekrose avk03.jpg\|thumb\|Wet gangrene of foot.]]
	* Usually due to peripheral arterial or venous disease, but can also be sequelae of trauma or burns causing vascular injuries.		* Usually due to peripheral arterial or venous disease, but can also be sequelae of trauma or burns causing vascular injuries.
	* Presents with swollen, pale, soft tissue, often with a putrid smell and purulent discharge.		* Presents with swollen, pale, soft tissue, often with a putrid smell and purulent discharge.

2025-05-21T18:36:30Z

Clinical Features

← Older revision		Revision as of 18:36, 21 May 2025
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	==Clinical Features==		==Clinical Features==
			[[File:DMgas gangrene.jpg\|thumb\|Wet gangrene with presumed gas.]]
	* Usually due to peripheral arterial or venous disease, but can also be sequelae of trauma or burns causing vascular injuries.		* Usually due to peripheral arterial or venous disease, but can also be sequelae of trauma or burns causing vascular injuries.
	* Presents with swollen, pale, soft tissue, often with a putrid smell and purulent discharge.		* Presents with swollen, pale, soft tissue, often with a putrid smell and purulent discharge.