Managing foot infections in patients with diabetes

Managing foot infections in patients with diabetes

Tan N J; Tan J S

Infections in Medicine

2006

2006-04

The evaluation of foot infections in patients with diabetes requires a careful physical examination. Wound culture; a probeto-bone test; and imaging studies, such as plain radiography and MRI, should be performed when indicated. Patients with radiographic evidence of osteomyelitis, regardless of the condition of the overlying skin, should have surgical consultation to obtain culture and biopsy samples and to remove affected bone if necessary. If possible, antimicrobial therapy should be based on culture results. Empiric antimicrobial therapy for superficial infections should cover Staphylococcus aureus and P-hemolytic streptococci. For moderate to severe infections, broad antimicrobial coverage should include Gram-positive cocci, Gram-negative bacilli, and anaerobes. Patients with persistent draining ulcers despite appropriate antimicrobial therapy should be evaluated for osteomyelitis and retained infected or necrotic tissue.

diabetes; foot infections; Infectious Diseases; osteomyelitis

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Journal Article

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