Treatment of necrotizing fasciitis with quinolones

To evaluate the effect of high dose quinolones therapy in patients with necrotizing fasciitis.

Descriptive analytical study.

The department of Plastic and reconstructive surgery, Hayatabad Medical Complex, Peshawar, from January 2001 to March 2002.

Twenty consecutive patients, diagnosed with necrotizing fasciitis, were treated with intravenous quinolones (400 mg 8 hourly). The response was evaluated in terms of subsidence of fever and C-reactive proteins levels.

Majority of the patients was male (60%). Lower limb involvement was most commonly involved (70%). The most common initiating cause was injection abscess (45%). Majority of the cultures showed polymicrobial infection (90%). The most common isolate was Streptococcus pyogenes (65%). Majority of the patients showed excellent response with intravenous quinolones (Ciprofloxacin) in high doses in 24-48 hours. Only two patients (10%) failed to respond to therapy due to severe infection and delay in seeking treatment.

Intravenous quinolones (Ciprofloxacin) in high doses are effective in controlling necrotizing soft tissue infections.