Diabetic foot infections

Abstract

Foot infections are common and serious problem in patients with diabetes which can lead to lower limb amputations. Diagnosis in many cases can be delayed due to the lack of typical clinical signs. In patients with mild infections who did not previously received antibiotics infection is usually caused by G(+) cocci. More severe soft tissue infections are polymicrobial and empiric therapy must include broad spectrum antibiotics. Mild and moderate infections can be treated on outpatient basis. Chronic soft tissue infection can lead to osteomielitis. Diagnosis of bone infection is difficult and may require bone biopsy or magnetic resonance imaging. In some cases osteomielitis can be treated conservatively but therapy should last for at least 6 weeks. Treatment should always cover Staphylococcus aureus and initially antibiotics should be given intravenously. Antibiotic therapy for not infected wounds is not recommended. Multidisciplinary approach to treatment of diabetic foot infection is necessary.