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Diabetic Foot Infection - #MEDSHED

Updated: Apr 6


 


 

Diabetic Foot Infection - #MEDSHED


Pathogenesis

Diabetes, vascular compromise, peripheral neuropathy, and impaired immune function = high risk of foot infection. Exacerbated by peripheral neuropathy. Severe complications include osteomyelitis and necrotizing fasciitis. 130,000 lower extremity amputations secondary to DFI in the US (2016).


Target Pathogens

50 - 80% of cases are polymicrobial

Gram positive: Staphylococcus sp (MRSA accounts for ~15%), Streptococci sp, and Enterococcus

Gram negative: Enterobacteriacae (Escheriscia, Proteus, Klebsiella etc), Pseudomonas

Anaerobes (~33%): Bacteroides sp, Prevotella sp


Antibiotics

Coverage for Gram positive (w/out MRSA), Gram negatives (+Pseudomonas), and anaerobes

Pipericillin-tazobactam

Cefepime*/metronidazole

Levofloxacin*/metronidazole

Meropenem


PLUS

Coverage for MRSA

Vancomycin

Daptomycin

Linezolid


*May consider ceftriaxone w/out concerns for Pseudomonas


PHARMWYZE SITREP Newsletter: https://www.pharmwyze.com/sitrepnewsletter


Not medical advice. Educational purposes only. No relationships to report.





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