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Title: Optimal antibiotics for necrotizing soft tissue infections

Category: Infectious Disease

Keywords: Necrotizing infection, antibiotic selection (PubMed Search)

Posted: 4/27/2025 by Robert Flint, MD

In the April edition of Annals of EM, there are opposing view points on the optimal antibiotic regiment for necrotizing soft tissue infection. One group proposes linezolid alone will cover all the worrisome pathogens namely group A Strep and Staph. There are less side effects including C. Diff infection with this medication. Another group suggests sticking to vancomycin plus/minus BLactam along with clindamycin. Their arguement centers around clindamycin is useful as an antitoxin more so than its antibacterial property. 

Both offer reasonable evidence and neither is compelling enough to say one is superior to the other.

References

Optimal antibiotic Selevtion for Necrotizing soft tissue infections. Annals of Emergency Medicine. April 2025. Vol 8, No. 4 358-360


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