Necrotizing soft tissue infection

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Classification

Although it is classically divided into Type 1 (polymicrobial) and Type 2 (monomicrobial), others have proposed an extension to include Type 3 (water-associated) and Type 4 (fungal).

Management

Eagle Effect

  • Originally, referred to decreased effectiveness of penicillins at high concentrations
  • Now, refers to decreased effectiveness of penicillins at high bacterial burden (when in stationary phase)
  • Clindamycin kills enough of the bacteria that are in stationary phase that the bacteria return to logarithmic growth phase, where penicillins are more effective

Further Reading