IDSA - Approach to Treating a Patient With Diabetic Foot Osteomyelitis When to consider a trial of nonsurgical treatment: • No persisting sepsis (after 48–72 h if on treatment) • Patient can receive and tolerate appropriate antibiotic therapy • Degree of bony destruction has not caused irretrievable compromise to mechanics of foot (bearing in mind potential for bony reconstitution) • Patient prefers to avoid surgery • Patient comorbidities confer high risk to surgery • No contraindications to prolonged antibiotic therapy (eg, high risk for C. difficile infection) • Surgery not otherwise required to deal with adjacent soft tissue infection or necrosis When to consider bone resection: • Persistent sepsis syndrome with no other explanation • Inability to deliver or patient to tolerate appropriate antibiotic therapy • Progressive bony deterioration despite appropriate therapy • Degree of bony destruction irretrievably compromises mechanics of foot • Patient prefers to avoid prolonged antibiotics or to hasten wound healing • To achieve a manageable soft tissue wound or primary closure • Prolonged antibiotic therapy is relatively contraindicated or is not likely to be effective (eg, presence of renal failure) #Diabetic #Foot #Osteomyelitis #Infection #Resection #Indications #nonsurgical #nonoperative #management #IDSA
