General principles

Intravenous therapy is required for initial empirical therapy for infection associated with systemic features or involving deeper tissues (such as bones, joints or tendons), and for patients with localised infection who have risk factors for severe disease (eg liver disease, iron overload, immune compromise due to immunosuppressive medications, diabetes or malignancy).

Antibiotic choice depends on whether the wound is associated with significant trauma or has been immersed in soil- or sewage-contaminated water.

For empirical therapy for patients with sepsis or septic shock (for definitions, see here for adults, or here for neonates, infants and children), see Empirical therapy for necrotising skin and soft tissue infection associated with a wound that has been immersed in water.