Do you treat diabetic foot osteomyelitis without surgical resection with a fixed 6-week antibiotic course, or do you shorten duration based on clinical and inflammatory marker response?
The real key factor in successfully treating diabetic foot infections is adequate debridement (and sometimes amputation, like TMA) in the setting of infected bone. We have excellent Podiatrists at our County Hospital and VA, and foot/ankle and vascular surgeons at our University Hospital. You can't ...
I usually treat with a full 6-week course if I know that the bone is infected. That being said, there is almost no data to support 6 weeks - the data show that 2 weeks is likely too short and 12 weeks is likely too long, but sadly, we have no great studies to support 6 weeks.
No arbitrarily fixed duration. Generally 6+ weeks, but the key issues are: 1) restoration of large- and small-vessel blood supply, to the degree technically feasible; 2) debridement of necrotic soft tissue and bone, often including amputation; and 3) administration of oral or IV antibiotics with rel...
I would treat with 6 weeks of antibiotics; however, there is a lot of data to support considering transition to oral antibiotics in certain cases, or to consider a hybrid of 2 weeks of IV antibiotics followed by oral antibiotics to complete the remaining 4 weeks. As far as inflammatory markers, I te...