Adult Outpatients: Skin and Soft-Tissue Infections: Diabetic Foot Ulcer

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Doses provided in this table are for patients with normal renal and hepatic function. Click on drug link to go to dosing guidelines.  Some antimicrobials are restricted (ID-R).  Click on link for guidelines on obtaining authorization.

Diagnosis

Common Pathogens

Drug(s) of First Choice

Comments

Diabetic Foot Ulcer

Localized cellulitis without systemic signs or symptoms, no osteomyelitis 

S. aureus

Streptococci

Enterobacteriaceae

 

Clindamycin 300 mg PO TID

 

If patient has been treated with antibiotics within the past month ADD:

LevofloxacinID-R: VASF 750 mg PO daily

OR

Ciprofloxacin 500 mg PO BID   

While infections may be polymicrobial, they frequently respond to Gram-positive coverage alone.

 

Increasing rates of MRSA in the community may be a cause for failure to respond to initial therapy. 

 

Consider osteomyelitis especially if there is a failure to respond to therapy.

 

7-14 days of treatment is generally sufficient, duration should be based on clinical response.