Pseudomonas Foot Osteomyelitis — SCE Infectious Diseases MCQ

Correct answer: C — Use source control and culture-directed antipseudomonal treatment, with route and duration determined by bone resection, vascular supply and response after review with review

The best answer is “Use source control and culture-directed antipseudomonal treatment, with route and duration determined by bone resection, vascular supply and response after review with review”. Deep bone or tissue microbiology after source control is more reliable than surface swabs; definitive treatment follows the actual organism and surgical context. “Treat Candida empirically without fungal culture” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Treat tetanus with antibiotics alone and ignore immunisation status” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Use empirical Escherichia coli therapy despite deep culture” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Use antistaphylococcal monotherapy despite the recovered pathogen” is less appropriate because it conflicts with the clinical discriminator or cited guidance.

Reference: NICE NG19 diabetic-foot infection recommendations: https://www.nice.org.uk/guidance/ng19/chapter/Recommendations