Exam 3 - Diabetic Foot Infection Flashcards
What are risk factors for DFI
neuropathy
angiopathy/ischemia
immunologic defects
poor wound healing
how to diagnose DFI
local signs of infection +/- purulence
discolored tissue and foul odor
what cultures should be obtained for DFI
wound (except mild)
bone
blood (reserve for severe)
what are the causative pathogens for infected ulcers
s. aureus
strep spp.
what are causative pathogens for chronic infected ulcers
s. aureus
strep spp.
enterobacter
anaerobes
what are causative organisms for macerated ulcer from soaking
s. aureus
strep spp.
pseudomonas
what are causative organisms for chronic non-healings
s. aureus
strep spp.
enterococcus
pseudomonas
anaerobes
what are MRSA risks in DFI
previous MRSA infections in a year
local MRSA >30-50
recent hospitalizations
failed non-MRSA abxs
what are pseudomonas risks in DFI
history of pseudo
soaking feet in water
warm climate
severe infx/failed therapies
what should be covered in mild DFI
MSSA
Strep spp
what is first line for mild DFI
cephalexin, clindamycin x2-3 weeks
how would you treat mild DFI if there were recent abxs
switch to augmentin, levo, or moxi
how would you treat mild DFI if there was MRSA risk
switch to bactrim or doxy
what should be covered for moderate DFI
MSSA
Strep spp.
Enterobacter
Anaerobes
what is first line for moderate DFI
moxi
augmentin
cipro/levo + clinda/metro
x2-3 weeks
how would you treat moderate DFI if there was pseudomonas risk
switch to cipro/levo + clinda/metro
how would you treat moderate DFI if there was MRSA risk
add doxy, linezolid, vanc, bactrim
what should be covered in severe DFI
MSSA
strep spp.
enterobacter
anaerobes
pseudomonas
what is first line for severe DFI
Pip/tazo
carbapenem (NOT ertapenem)
Cefepime + clinda/metro
x 2-3 weeks
how would you treat severe DFI that has MRSA risk
add vanc or linezolid or dapto
