Diabetic Foot Infections
Please note this part of policy is under review
Diabetic foot ulcers should be treated by a MDT foot care team as this can reduce amputation rates. Refer urgently to hospital foot service (01786 431133) or diabetes consultant if moderate or severe (FVRH 01324 566000 Page 1965). Cultures should always be taken from infected wounds preferably before the initiation of antibiotics and repeated if there is treatment failure or in severe cases. (There is no need to routinely culture non- infected ulcers). The preferred specimens for culture are purulent aspirates, curettage of the post-debridement wound base, punch biopsy and extruded or biopsied bone where possible.
If patients have had MRSA previously, have risk factors for MRSA (e.g. previous hospital admission, transfer from another hospital, admission from nursing or care home) or screen positive for MRSA, they should be managed as if MRSA positive.
NB - If cultures are resistant to clarithromycin, clindamycin will also be ineffective.
Long term antibiotic therapy needs specialist multidisciplinary discussion and must include regular swabbing.