A 65 Years male Type 2 Diabetic and Hypertension since 15 years. Develop marked neuropathy in both feet. Develop diabetic ulcer at base of right great toe in December. No improvement after dressing and antibiotics treatment. Develop osteomyelitis in first metatarsal. Vascular Doppler is normal. Amputation done at mid-metatarsal level in August with KCI VAC dressing.
After a month wound show culture positive for staphylococcus and Proteus Mirabilis. Sensitive I/V antibiotics started Amoxiclav + Amikacin after 5 days grafting done with vac dressing. Same antibiotics continued for 5 more days and when dressing open graft was in place but culture again positive for Proteus Mirabilis and Morganella Morganii. Proteus sensitive to similar antibiotics but other organism is only sensitive to meropenem, Amikacin & Tazobactum. Patient now on meropenem 1 gm TDS & Amikacin 750 mg OD from 5 days. But…
