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Advances in Prevention and Empirical Treatment of Diabetic Foot Infection

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Diabetic Foot Ulcer

Abstract

At some time in their life, 15% of people with diabetes develop foot ulcers, which are highly susceptible to infection. Foot infection in diabetes may spread rapidly leading to overwhelming tissue destruction and amputation. Management of infection in diabetic foot needs a multidisciplinary approach and it is vital to achieve microbiological, wound, vascular, mechanical, and educational control. If infection is not controlled it can spread rapidly, causing extensive tissue necrosis and taking the foot into stage 5. At presentation, the organism responsible for infection cannot be predicted from clinical experience. However, antibiotic selection should be empirical and initially related to patient factors and the severity of the infection. In general, acute diabetic foot infections without prior antibiotic treatment are caused by aerobic Gram-positive organism and most commonly by Staphylococcus aureus (including methicillin-resistant strains). With time, the wound microbiologically becomes polymicrobial and includes anaerobes. For more severe infection, antibiotics with broad-spectrum coverage until culture results and clinical response is available should be prescribed. Coverage for methicillin-resistant organism (MRSA) should be considered based on local epidemiology and risk factors. The duration of treatment depends on the severity of infection, the involvement of bone and the patient’s response to treatment. Empirical antibiotic treatment, however, is not recommended for clinically uninfected wound.

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Author information

Authors and Affiliations

  1. Rajiv Gandhi Center for Diabetes & Endocrinology, Faculty of Medicine, J N Medical College & Hospital, Aligarh Muslim University, Aligarh, India

    Hamid Ashraf

  2. Retired Professor & Director Rajiv Gandhi Center for Diabetes & Endocrinology, Faculty of Medicine, J N Medical College & Hospital, Aligarh Muslim University, Aligarh, India

    Jamal Ahmad

  3. Diabetes & Endocrinology Superspeciality Center, Aligarh, India

    Jamal Ahmad

  4. Department of Microbiology, Faculty of Medicine, J N Medical College & Hospital, Aligarh Muslim University, Aligarh, India

    Anees Akhtar

Authors
  1. Hamid Ashraf
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  2. Jamal Ahmad
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  3. Anees Akhtar
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Editor information

Editors and Affiliations

  1. Department of Medical Microbiology, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia

    Mohammad Zubair

  2. Consultant, Diabetes & Endocrinology, Superspeciality Center, Aligarh, Uttar Pradesh, India

    Jamal Ahmad

  3. Ex-Chairperson-Department of Microbiology, Former Dean-Faculty of Medicine, J N Medical College & Hospital Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

    Abida Malik

  4. Research Associate, Bioanalytical Department, AXIS Clinicals, Hyderabad, Telangana, India

    Mallikarjuna Rao Talluri

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Ashraf, H., Ahmad, J., Akhtar, A. (2021). Advances in Prevention and Empirical Treatment of Diabetic Foot Infection. In: Zubair, M., Ahmad, J., Malik, A., Talluri, M.R. (eds) Diabetic Foot Ulcer. Springer, Singapore. https://doi.org/10.1007/978-981-15-7639-3_12

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  • DOI: https://doi.org/10.1007/978-981-15-7639-3_12

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  • Online ISBN: 978-981-15-7639-3

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