in case of overly infected diabetic foot ulcers with necrotic soft tissue & bone infection with high uncontrolled blood sugar ,what is the best suggested strategy to start the case management?
Linezolid oral until you have your bone culture back, or you could start 6 weeks IV vancomycin.
You must control the elevated blood glucose. You must prescribe broad spectrum antibiotics for aerobic and anaerobic organisms initially. Once vultures are known then convert. Ask your local microbiologist for expert advice. Get a vascular opinion early on to
ensure pulses present.
If it is a severe infection like you are describing until culture and sensitivity results have been returned we start with piperacillin/tazobactam at the recommendation of our infectious disease department
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