Diabetic Foot Infection + Animal / Human Bite

Diabetic Foot Infection

• Patient with diabetes are at high risk for foot ulcers because neuropathic damage, compromised blood flow to the lower extremities and poor wound healing

• It is important patients with diabetes follow recommendations for proper foot care because ulcers can progress to foot infection, which can require amputation

Mild Superfical Infection without Systemic Symptoms

• Cephalexin

• Dicloxacillin

• Beta - lactam allergy?

  • Clindamycin

Moderate to Severe Diabetic Foot Infection: No MRSA activity needed

• Unasyn

• Ertapnem

• Ceftriaxone

• Levofloxacin

• Moxifloxacin

Moderate to Severe Diabetic Foot Infection: Pseudomonas and/or MDR gram negative activity needed

• Pip/tazo

• Cefepime

• Meropenem

• Imipenem

Moderate to Severe Diabetic Foot Infection: MRSA activity needed

• Add:

  • Vancomycin

  • Linezolid

  • Daptomycin

Moderate to Severe Diabetic Foot Infection: Anaerobic activity needed

• Use regimen with anaerobic activity (Pip/tazo)

• OR

• + Metronidazole

Treatment Duration

• No bone involvement → 2 - 4 weeks

• Osteomyelitis → 4 - 6 weeks

• Amputation with NO residual infection → 2 - 5 days

Animal and Human Bite

• Pasteurella (animal bite)

• Eikenella corrodens (human bite)

Animal and Human Bite Treatment

• Immunocompromised patient:

  • Preemptive antibiotic

• First Line:

  • Augmentin for 3 - 5 days

• Beta - lactam allergy?

  • Bactrim or Doxycycline + Clindamycin + Metronidazole