Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content +++ ASYMPTOMATIC BACTERIURIA +++ Population ++ Nonpregnant women. +++ Recommendations +++ IDSA 2019 ++ Do not treat asymptomatic bacteriuria with antibiotics. Only screen pregnant women and patients undergoing urologic procedures. +++ Source ++ https://doi.org/10.1093/cid/ciy1121 +++ COMMON COLD +++ Population ++ Healthy adults (those without chronic lung disease or immunocompromising conditions). +++ Recommendation +++ Annals of Internal Medicine 2016 ++ Do not prescribe antibiotics for the common cold. +++ Source ++ http://annals.org/aim/fullarticle/2481815/appropriate-antibiotic-use-acute-respiratory-tract-infection-adults-advice-high +++ Comment ++ Harm from antibiotics outweighs benefits, as all causes of common cold are viral. +++ DIABETIC FOOT INFECTIONS, INPATIENT MANAGEMENT +++ Population ++ Hospitalized adults older than 18 y with diabetic foot problems. +++ Recommendations +++ IDF 2017 ++ Assess arterial perfusion and need for revascularization. Debride callus and necrotic tissue to fully visualize wound, measure depth and extent. Obtain cultures: tissue or bone specimen preferred; deep swab only after debriding wound. Obtain x-ray of all new diabetic foot infections. Obtain MRI if osteomyelitis suspected and plain film is not diagnostic. Request surgical consult for deep abscesses, compartment syndrome, and necrotizing soft tissue infection. Treat clinically infected wounds with antibiotics: 1–2 wk for mild-to-moderate infections. 3 wk for more serious skin and soft tissue infections. 6 wk for osteomyelitis. +++ Source ++ https://www.idf.org/e-library/guidelines/119-idf-clinical-practice-recommendations-on-diabetic-foot-2017.html +++ Comment ++ A deep space infection may have deceptively few superficial signs. +++ NICE 2016 ++ Every hospital should have a multidisciplinary foot care team to assess and treat any diabetic patient with foot problems. Every patient with a diabetic foot problem should undergo an assessment for: Need for debridement, pressure off-loading. Vascular inflow. Infection of the foot. Glycemic control. Neuropathy. If diabetic foot infection is suspected, obtain culture (soft tissue or bone sample preferred, or deep swab after debriding wound). If osteomyelitis is suspected, obtain an x-ray; if x-ray is normal, obtain an MRI. Provide off-loading for diabetic foot ulcers. For mild diabetic foot infections, treat with empiric antibiotics that provide good coverage of gram-positive organisms. For moderate-to-severe diabetic foot infections, treat with empiric antibiotics that provide coverage of gram-positive, gram-negative, and anaerobic bacteria. +++ Source ++ https://www.nice.org.uk/guidance/ng19 +++ Comments ++ The diabetic foot care team should include: Diabetologist. Surgeon with expertise managing DM foot problems. DM nurse specialist. Podiatrist. Tissue viability nurse. Biomechanic and orthotic specialist. Unless part of a clinical trial, do not treat diabetic foot ulcers with: Electrical stimulation therapy, ... GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessMedicine 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessMedicine Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options