Empiric antibiotics should continue

Empiric antibiotics should continued until debridement is no longer needed, clinical improvement has be seen, and fever has subsided for at least 72 hours. If GAS is suspected, the combination of clindamycin and penicillin has shown superior clinical efficacy to penicil1ins alone (Reference 85). Pharmacologically, clindarnycin may suppress toxin production, modulate cytokin production, and sustain bacterial killing during slow phases of growth when penicillins are ineffective. Empiric coverage for polymicrobial infections should include agents with an expanded spectrum of activities against gram-negative organisms and anaerobes.