Diabetic foot infections are a significant contributer to osteomyelitis and lower extremity amputations.
Diabetic foot infections are a significant contributer to osteomyelitis and lower extremity amputations. Early identification and wound care with debridement are crucial for prevention of disease progression. DFIs start as ulcers with common gram positive skin pathogens, such as staphylcocci and streptococci species. Recurrent and deep infections are often polymicrobial. Methicillin-resistant staphylcoccous aeurus, gram negative rods including Pseudomonas, and obligate anaerobes are potential targets. Common empiric regimens for moderate to severe infections include piperacillin-tazobactam OR cefepime with metrondazole AND vancomycin. PIP-TAZO includes coverage for Pseudomonas and anaerobes. Cefepime comined with metronidazole offers a similiar spectrum without enterococcus sp. Vancomycin is effective against gram positive organisms, including MRSA and enterococcus. The Vanc/Zosyn combo may contribute to AKI. Maximize tissue and bone penetration with higher end of initial dosing. Reference your local antibiogram for best options and narrow when appropriate. Check out my #PHARMFAX on IV/PO alternatives for MRSA, PSA, and ESBL bugs. Links are below in the description, and I hope you learned something new. Recommended Read/Watch ESBL ABX: https://www.instagram.com/p/CtvagCGA544/ MRSA ABX: https://www.instagram.com/p/CpnQvfkoIyU/ PSA ABX: https://www.instagram.com/reel/CtQfaB7gJOj/ The ALL PHARMWYZE SOURCE (including references) | www.pharmwyze.com #diabetes #dfi #mrsa #pseudomonas #infectiousdisease #id #foamed #pharmacist #pharmwyze #pharmfax #criticalcare #emergencymedicine #studentpharmacist #nursingstudent #medicalstudent #pharmacy #medicine #nursing #meded
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