Gas Gangrene (Clostridial Myonecrosis) Guidelines

Updated: May 08, 2023
  • Author: Hoi Ho, MD; Chief Editor: John L Brusch, MD, FACP  more...
  • Print

Guidelines Summary

In 2014, the Infectious Diseases Society of America (IDSA) issued an update of the Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections [47] and had the following recommendations for the evaluation and management of necrotizing fasciitis, including Fournier gangrene:

  • Prompt/urgent surgical consultation is necessary for patients with aggressive infections associated with signs of systemic toxicity or suspicion of necrotizing fasciitis or gas gangrene.
  • Empiric antibiotic treatment should be broad-spectrum (eg, vancomycin or linezolid plus [1] piperacillin-tazobactam or a carbapenem or [2] ceftriaxone and metronidazole).
  • Penicillin plus clindamycin is recommended for treatment of documented clostridial gas gangrene or group A streptococcal necrotizing fasciitis.
  • Hyperbaric oxygen (HBO) therapy is not recommended because it has not been proven as a benefit to the patient and may delay resuscitation and surgical debridement.