Diabetic foot infection: antibiotic therapy recommendations

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Foot

Possible therapeutic alternatives

Diabetic foot (mild, outpatient therapy)

Common pathogens

Clindamycin 300mg qid or

Ceclor 250mg po q8h or Keflex 250 to 500mg q6h or

Dicloxacillin 250mg po q6h or

Amoxicillin/clavulanate( Augmentin ) 875/125mg PO q12h x 14 days

Cefazolin 1-2g IV q8h

Ampicillin-sulbactam 3 grams IV q6h

Nafcillin or oxacillin 2 grams IV q4h

Diabetic foot ulcer Complicated (Hospitalized patient)

Common pathogens

Mild:

Ciprofloxacin 750mg po bid + (Metronidazole 500mg po q6-8h or Clindamycin 300mg po qid).

Severe:

Ampicillin-sulbactam 1.5 to 3 grams IVPB q6h or

Ticarcillin-clavulanic acid 3.1 grams IVPB q6h or

Piperacillin-tazobactam 3.375 grams IVPB q6h or

[Ceftazidime 2 grams IV q8h or Cefepime 2 grams IV q12h or Cefotaxime 2 grams IV q8h or Ceftriaxone 2 grams IV qd ] + Metronidazole 500mg PO or IV q6h

Diabetic foot (limb-threatening)

Common pathogens

Clindamycin 900mg IV q8h + [Ciprofloxacin 400mg IV q12h or tobramycin ]

Clindamycin 900mg IV q8h + [Ceftazidime 2g IV q8h or Cefepime 2g IV q12h or Cefotaxime 2g IV q8h or Ceftriaxone 2g IV qd]

Piperacillin-tazobactam 3.375g IV q4h

Vancomycin 1g IV q12h + Aztreonam 2g IV q8h + Metronidazole 500mg IV q6h

Imipenem 500mg IV q6h or meropenem 1g IV q8h

Diabetic foot ulcer

Antimicrobial Series
References

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