SEP 2.06 Sepsis - toxic shock syndrome

Content version: U-24.2
Updated: 10/20/2025 - 15:04

Recommendations

≥ 18 years
	Dosage	Remarks
1st choice	flucloxacillin IV 6 g/24 h minimum 7 days + clindamycin IV 600 mg three times daily minimum 7 days	For unknown causative organism (group A streptococcus or S. aureus) Loading dose 1 g flucloxacillin as a bolus, then continuous infusion. If continuous infusion is not possible, then 1 g flucloxacillin six times daily.
	benzylpenicillin IV 2 million IU six times daily minimum 7 days + clindamycin IV 600 mg three times daily minimum 7 days	Due to group A streptococcus
	flucloxacillin IV 6 g/24 h minimum 7 days of flucloxacillin IV 1 g six times daily minimum 7 days	Caused by S. aureus toxin If continuous infusion: loading dose 1 g flucloxacillin as a bolus

≥ 18 years

Indications: In case of penicillin allergy*
	Dosage	Remarks
	cefazolin IV 2000 mg three times daily minimum 7 days + clindamycin IV 600 mg three times daily minimum 7 days	For unknown causative organism (group A streptococcus or S. aureus)

Comments

*See protocol Policy for allergy to antibiotics | Radboud UMC

Consult with a clinical microbiologist/infectiologist about administration of immunoglobulins.

For group A streptococci: notifiable disease, group B2.