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Methicillin-Resistant Staphylococcus aureus in Diabetic Foot Infections

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Abstract

Diabetic foot ulcers are often complicated by infection. Among pathogens, Staphylococcus aureus predominates. The prevalence of methicillin-resistant S. aureus (MRSA) in infected foot ulcers is 15–30% and there is an alarming trend for increase in many countries. There are also data that recognize new strains of MRSA that are resistant to vancomycin. The risk for MRSA isolation increases in the presence of osteomyelitis, nasal carriage of MRSA, prior use of antibacterials or hospitalization, larger ulcer size and longer duration of the ulcer. The need for amputation and surgical debridement increases in patients infected with MRSA. Infections of mild or moderate severity caused by community-acquired MRSA can be treated with cotrimoxazole (trimethoprim/sulfamethoxazole), doxycycline or clindamycin when susceptibility results are available, while severe community-acquired or hospital-acquired MRSA infections should be managed with glycopeptides, linezolide or daptomycin. Dalbavancin, tigecycline and ceftobiprole are newer promising antimicrobial agents active against MRSA that may also have a role in the treatment of foot infections if more data on their efficacy and safety become available.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. 1st Department of Propaedeutic and Internal Medicine, Athens University Medical School, Athens, Greece

    Ioann Eleftheriadou,  Nicholas Tentolouris & Vasiliki Argiana

  2. Department of Diabetic Medicine, Tameside General Hospital, Ashton-Under-Lyne, UK

    Edward Jude

  3. Department of Medicine, Manchester Royal Infirmary, Manchester, UK

    Andrew J. Boulton

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  1. Ioann Eleftheriadou
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  2. Nicholas Tentolouris
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  3. Vasiliki Argiana
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Correspondence to Nicholas Tentolouris.

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Eleftheriadou, I., Tentolouris, N., Argiana, V. et al. Methicillin-Resistant Staphylococcus aureus in Diabetic Foot Infections. Drugs 70, 1785–1797 (2010). https://doi.org/10.2165/11538070-000000000-00000

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