From the Research
For a puncture wound to the foot through a sandal, the antibiotic of choice is typically amoxicillin-clavulanate (Augmentin) at a dose of 875/125 mg orally twice daily for 5-7 days, as it provides broad-spectrum coverage against both skin flora (Staphylococcus aureus) and environmental contaminants, including Pseudomonas aeruginosa 1. This recommendation is based on the most recent and highest quality study available, which highlights the importance of effective antibiotic treatment in managing Pseudomonas aeruginosa infections 1.
When considering the management of puncture wounds to the foot, it is essential to prioritize thorough wound cleaning, including irrigation with sterile saline and removal of any foreign material, as well as considering tetanus prophylaxis if vaccination is not current 2. Elevation and regular wound checks are also crucial in preventing infection and promoting healing.
In cases where Pseudomonas is a particular concern, alternatives such as ciprofloxacin 500 mg twice daily for adults may be considered 3. Additionally, if MRSA is suspected, trimethoprim-sulfamethoxazole (Bactrim DS) one tablet twice daily may be an appropriate option.
It is also important to note that antibiotics are particularly indicated for deep punctures, those with signs of infection (redness, swelling, warmth, drainage), or in immunocompromised patients 4, 5. The broad-spectrum coverage of amoxicillin-clavulanate addresses the polymicrobial nature of these injuries while providing activity against beta-lactamase producing organisms commonly found in these wounds.
Key considerations in the management of puncture wounds to the foot include:
- Thorough wound cleaning and irrigation
- Removal of any foreign material
- Consideration of tetanus prophylaxis
- Elevation and regular wound checks
- Antibiotic treatment with amoxicillin-clavulanate or alternative options as needed
- Monitoring for signs of infection and adjusting treatment accordingly.