Diabetic Foot Infections

Diabetic foot infections (DFI) are diagnosed by two or more classic findings of inflammation (redness, swelling, warmth, and tenderness) or purulent drainage within an existing diabetic foot wound. Wounds without clinical evidence of soft tissue or bone infection often do not require antibiotic therapy. When infection is present, empiric antibiotic regimens must be based on the available clinical and local epidemiologic data, but definitive therapy should be based on cultures of infected tissues or clinical response. Consideration of methicillin-resistant Staphylococcus aureus (MRSA) coverage should be given when local prevalence is high, in patients with a prior history of MRSA infection, or when the systemic manifestations are severe. Surgical intervention and vascular assessment play key roles in the management of many DFI; deep DFI require incision, drainage, and debridement. Redistribution of pressure off of the wound is a tenet in the management of DFI.