Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Spread from Ulcer

Common Pathogens

Staphyloccocus aureus

MRSA Risk Factors:

  • Evidence of MRSA infection elsewhere

  • Nasal colonization with MRSA

  • Injection drug use

Streptococci spp

Gram negative organisms

Anaerobes

Empiric IV Antimicrobial Regimen (Adults)

Ceftriaxone 2g IV Q24H

PLUS

Metronidazole 500mg PO Q12H

Use IV if unable to take PO

If MRSA Risk Factors Present

ADD

Vancomycin : target trough of 15-20 ug/mL
see dosing nomogram

If patient cannot be dosed using nomogram
contact Pharmacy.

Diabetic Foot Infections

Diabetics may have neuropathy, peripheral vascular disease, pressure-induced trauma, and poor glucose control, which increase risk of tissue damage and osteomyelitis.

Ulcers without inflammation may not require antibiotics.

Ulcers with superficial inflammation may be treated with oral antibiotics.

Ulcers with extension to fascia should be treated with intravenous antibiotics.