Diabetic Foot Infections

Question 1

What are classic findings of a diabetic foot infection?

Answer 1

1. Redness
2. Swelling
3. Warmth
4. Pain
5. Purulent
6. Drainage
7. Tenderness

2+ = Infected

Question 2

What are the secondary findings of a diabetic foot infection?

Answer 2

1. Non-purulent secretions
2. Discolored granulation tissue
3. Foul odor

Question 3

What are the MRSA and Psuedomonas Risk factors?

Answer 3

MRSA= Previous Hx, High local prevalence, severe infection

Pseudomonas = Warm climate, water exposure, high local prevalence

Question 4

What are the etiological agents of DFIs?

Answer 4

1.) Aerobic + Cocci: Staphylococcus or Streptococcus
2.) Aerobic - Cocci: P. aeruginosa
3.) Anaerobes

Question 5

Mild Diabetic Foot Infection Criteria

Answer 5

0.5-2cm Erythema

Question 6

Moderate Diabetic Foot Infection critiera

Answer 6

2 + cm Erythema or involving structures deeper than skin.

Question 7

Severe Diabetic Foot infection criteria

Answer 7

Local infection w/ 2 SIRS criteria.

Question 8

Mild DFI empiric treatment

Answer 8

Doxycycline OR Bactrim

Question 9

Mild DFI De-escalation

Answer 9

Cephalexin OR Augmentin OR Clindamycin

-=cephalexin
+=Augmentin
Anaerobe=Clindamycin

Question 10

Mild DFI Treatment Duration

Answer 10

1-2 weeks.

Question 11

Moderate-Severe DFI Empiric Therapy

Answer 11

1. Vancomycin + Piperacillin
2. Vancomycin + Cefepime + Metronidazole
3. Vancomycin + meropenem

Question 12

Moderate-Severe DFI De-Escalation

Answer 12

Ampicillin/Sulbactam
Cefoxitin
Ceftriaxone + Metronidazole
Ciprofloxacin + Clindamycin
Moxifloxacin
Ertupenem

Question 13

Moderate DFI treatment duration

Answer 13

1-3 weeks.

Question 14

Severe DFI treatment duration

Answer 14

2-4 weeks.