09-12-2011, 11:39 AM
A 65 year old patient with diabetic foot over his 4th metatarsal head for 3 mths comes to your office. He was prescribed to offload his foot but he is non-compliant. Now, he presents with dull throbbing pain with fever. Ulcer examination reveals: putrid-smelling wound notable also for a pus-filled 2.5 cm wide ulcer. A metal probe is used to probe the wound and it detects bone as well as a 3-cm deep cavity. The gram stain revals gram-positive cocci in chains, gram-positive rods, gram-negative diplococci, enteric-appearing gram-negative rods, tiny pleomorphic gram-negative rods, and a predominance of neutrophils. Which antibiotics are used now till you get back the blood and drainage cultures?
1. Vancomycine, 1g IV BID
2. Linezolid, 600 mg PO tid
3. Clinidamycin, 600 mg PO tid
4. Ampicillin/ sulbactam, 1.5 g, IV q 4h
5. Metronidazole, 500 mg PO qid
1. Vancomycine, 1g IV BID
2. Linezolid, 600 mg PO tid
3. Clinidamycin, 600 mg PO tid
4. Ampicillin/ sulbactam, 1.5 g, IV q 4h
5. Metronidazole, 500 mg PO qid