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Saw this comment from Cornmerchant on another thread, but it is SO SO true, top marks to Cornmerchant:

"If we could only get the GPs to refer immediately to a podiatrist , the need for antibiotics would be reduced significantly. How many times do you see a patient that has had two or even three courses of AB and still the problem is there? It is because they do not understand the etiology of the IGTN and are not aware of the treatment available. I have never sent a patient for AB and removal of the offending nail spike has always resolved the problem"

 

I don't think anyone would disagree with that Simon!

regards CF

 

This is all true but the pt sees the gp 1st and has pus present so gets antibiotics. They dont refer to the podiatrist because most of the patients will not pay 2oo pounds plus bill. They eventually send to nhs podiatry after 2-3 visits. Many of these infections do resolve with antibiotic treatment so it becomes a numbers game.