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A systematic approach to diabetic foot infections

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Abstract

Foot infection is the most common reason for hospitalization and subsequent lower extremity amputation among persons with diabetes. Foot ulceration caused by diabetic neuropathy, trauma, and peripheral vascular disease can lead to a limb- or life-threatening infection. The optimum treatment of these potentially devastating conditions depends on a multidisciplinary approach that addresses the related or underlying disorders and thus ensures proper wound healing and a positive outcome. In addition to antibiotic therapy, severe soft-tissue or bone infections may necessitate surgical treatment, including drainage, débridement, and vascular reconstruction. Initial (empiric) antibiotic therapy should provide coverage against staphylococci and streptococci and should be revised according culture results. Antibiotic therapy is not indicated in clinically noninfected wounds. The duration of antibiotic treatment can range from 1 week for mild infections to 6 weeks or more for residual osteomyelitis and severe deep tissue infections. Aggressive (and sometimes repeated or staged) surgical intervention and appropriate antibiotic therapy can reduce the likelihood of a major amputation and the duration of hospitalization.

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Authors and Affiliations

  1. Department of Orthopaedics/Podiatry Division, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive-MC 7776, 78229, San Antonio, Texas

    Thomas Zgonis DPM, MT (ASCP) (Asst. Prof.)

  2. Weil Foot and Ankle Institute, Des Plaines, Illinois

    Thomas S. Roukis DPM

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  1. Thomas Zgonis DPM, MT (ASCP)
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  2. Thomas S. Roukis DPM
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Zgonis, T., Roukis, T.S. A systematic approach to diabetic foot infections. Adv Therapy 22, 244–262 (2005). https://doi.org/10.1007/BF02849934

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