Contiguous, Post-puncture of foot
- Local debridement/tetanus prophylaxis recommended.
- Risk factors for infection:
- diabetes
- deep puncture wound
- retained foreign body
- wound contamination with organic matter
Usual Pathogens
P. aeruginosa
Occasionally:
S. aureus
Streptococcus spp
Bacillus spp
Polymicrobial
Prophylaxis
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Ciprofloxacin | 750mg PO bid | 5 days |
Treatment
- Tetanus prophylaxis recommended.
- Surgical debridement always necessary.
- Culture recommended prior to institution of therapy.
| Empiric Therapy | Dose | Duration |
|---|---|---|
| Piperacillin-tazobactam | 4.5g IV q6h | minimum 2 weeks (IV + PO) |
Oral therapy
| Empiric Therapy | Dose | Duration |
|---|---|---|
| If P. aeruginosa confirmed: |
||
| Ciprofloxacin | 750mg PO bid | to complete minimum 2 weeks |
| If not P. aeruginosa, tailor oral antibiotics to C&S results. | ||