Diabetic Foot Infections
Antimicrobial prescribing: NHS Forth Valley
Diabetic foot ulcers should be treated by a multi-disciplinary foot care team as this can reduce amputation rates. Refer urgently to hospital foot service (Urgent SCI-Gateway Referral to 'Diabetes Foot Pathway' for single point triage to most appropriate clinic slot) or if moderate or severe requiring possible admission discuss first with Vascular On-Call team at QEUH (0141 201 1100, ask for Vascular Registrar).
Cultures should always be taken from infected wounds preferably before the initiation of antibiotics and repeated if there is treatment failure or in severe cases. (There is no need to routinely culture non- infected ulcers). The preferred specimens for culture are purulent aspirates, curettage of the post-debridement wound base, punch biopsy and extruded or biopsied bone where possible.
If patients have had MRSA previously, have risk factors for MRSA (e.g. previous hospital admission, transfer from another hospital, admission from nursing or care home) or screen positive for MRSA, they should be managed as if MRSA positive.
Long term antibiotic therapy needs specialist multidisciplinary discussion.