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Diabetic foot infections are one of the most feared complications of diabetes, since it is the most tangible consequence of the disease. While peripheral vascular disease and neuropathy may take a while, having a foot infection leading to osteomyelitis and possible amputations is disfiguring, costly, and has an impact on a person’s quality of life.
Vancomycin is the work-horse antibiotic every person reaches for. It is a glycopeptide that covers a wide range of gram positive bacteria, with its niche being in its coverage of methicillin-resistant staphylococcus aureus and Enterococcus spp. It is bacteriostatic, with dosing issues and highly nephrotoxic, however it is ubiquitous throughout any hospital in the United
This and (likely) the next post are a product of questions I got asked. For instance, do you need anaerobic coverage for diabetic foot infections? Depends, but see later. What organisms do you need to cover for cellulitis in those who have had water exposure? Cephalexin and quinolones, with some exceptions. We will talk about
The duration of therapy in vertebral osteomyelitis tends to be prolonged, usually 6 weeks of more. If there is anything to take away from this, is that at least 6 weeks of antibiotics for vertebral osteomyelitis is usually fine, but there are certain exceptions that may warrant longer duration of therapy. Some well cited data
Dr. Germophile 