The Curbsiders Internal Medicine Podcast #410 Diabetic Foot Infections
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Oct 2, 2023 Explore the diagnosis and treatment of diabetic foot infections, including risk stratification, vascular evaluations, and the importance of noninvasive studies. Learn about the challenges in assessing infections, starting antibiotics, and the use of oral antibiotics for serious infections. Discover treatment and management strategies, the significance of diabetes control, and the infectious disease specialty.
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Wound Swabbing
- Avoid swabbing chronic diabetic foot wounds at bedside.
- Cultures are best obtained through tissue or bone samples during debridement in a sterile OR setting.
Antibiotic Timing
- Hold off on antibiotics until cultures are obtained during debridement if the patient is clinically stable and a moderate infection.
- Immediate antibiotics are crucial for severe infections with systemic inflammation.
Empiric Antibiotic Choices
- Use oral antibiotics like augmentin or cephalexin for mild infections.
- Vancomycin plus a cephalosporin or piperacillin-tazobactam plus or minus metronidazole is suitable for moderate to severe infections.