▁sus pected ▁char cot ▁ne uro arth rop ath y , ▁or ▁those ▁whose ▁ul cers ▁do ▁not ▁improve ▁within ▁ 4 ▁weeks ▁of ▁standard ▁care ▁and ▁where ▁there ▁is ▁evidence ▁that ▁ex ud ate ▁is ▁of ▁syn ov ial ▁memb rane ▁in ▁origin . ▁When ▁o ste omy el itis ▁is ▁sus pected ▁to ▁be ▁involved ▁in ▁the ▁foot ▁ul cer , ▁but ▁not ▁ev iden ced ▁on ▁an ▁x - ray , ▁an ▁M RI ▁scan ▁should ▁be ▁obtained . ▁ ▁With ▁regards ▁to ▁inf ected ▁foot ▁ul cers , ▁the ▁presence ▁of ▁micro organ isms ▁is ▁not ▁in ▁itself ▁enough ▁to ▁determine ▁whether ▁an ▁in fection ▁is ▁present . ▁Sign s ▁such ▁as ▁infl amm ation ▁and ▁pur ul ence ▁are ▁the ▁best ▁indic ators ▁of ▁an ▁active ▁in fection . ▁The ▁most ▁common ▁organ ism ▁causing ▁in fection ▁is ▁st ap hy loc oc cus . ▁The ▁treatment ▁consists ▁of ▁deb ride ment , ▁appropriate ▁band ages , ▁man aging ▁peri pher al ▁ar ter ial ▁disease ▁and ▁appropriate ▁use ▁of ▁ant ib iot ics ▁( ag ain st ▁pseud omon as ▁aer ugin osa , ▁st ap hy loc oc cus , ▁stre pt oc oc cus ▁and ▁an a er obe ▁stra ins ), ▁and ▁ar ter ial ▁re vas cular isation . ▁ ▁Ant ib iot ics ▁The ▁length ▁of ▁ant ib i otic ▁courses ▁depend ▁on ▁the ▁sever ity ▁of ▁the ▁in fection ▁and ▁whether ▁b one ▁in fection ▁is ▁involved ▁but ▁can ▁range ▁from