Diabetic Foot Infections - Severe

Antibiotic Naive

ORAL THERAPY IS NOT APPROPRIATE

Co-amoxiclav 1.2g IV 8hrly (add Gentamicin as per protocol if required)

 

 

Antibiotic Naive - Penicillin Allergy

Ciprofloxacin PO 500mg bd (or IV if oral route unavailable) AND Vancomycin IV as per protocol (for gram +ve cover) AND Metronidazole 500mg IV 8hrly

Non-Antibiotic Naive - First Line

Co-Amoxiclav 1.2g 8hrly (AND Gentamicin IV as per protocol if septic) (add Vancomycin IV as per protocol if MRSA suspected)

Non-Antibiotice Naive - Penicillin Allergy

Ciprofloxacin PO 500mg bd AND Vancomycin IV as per protocol (for gram +ve cover) AND Metronidazole IV 500mg IV 8hrly

MRSA

Vancomycin IV as per protocol

Osteomyelitis

Add second agent to Vancomycin IV after review of sensitivities and discussion with microbiology

Oral switch

Review of sensitivities and discussion with microbiology

Notes

Please note this part of policy is under review

SYMPTOMS

  • Any infection accompanied by systemic toxicity (fever, chills, shock, vomiting, confusion, metabolic instability). The presence of critical ischaemia of the involved limb may make theinfectionsevere.

Duration

Treat for 14 days, review and continue or discontinue as appropriate

Follow guidance in IV to oral switch policy

If osteomyelitis present, discuss with medical mirobiologist and treat for at least 4-6 weeks