[Antibiotic therapy in the infected diabetic foot]

Foot infections in patients with diabetes cause substantial morbidity and may lead to amputation of a lower extremity. Management of diabetic foot infections involves evaluating and determining the severity of infection as the basis for selecting the appropriate approach to antibiotic treatment.

The purpose of our study is to analyse the etiologic agents commonly involved in diabetic foot infections and to appreciate the outcome of these infections with antibiotic therapy.

We included 90 patiens with infection of the diabetic foot, admitted in the Diabetes Clinic, "Sf. Spiridon" Hospital; wound swabs were collected from 79 infected ulcers. The seriousness of the infection was assesed using the IDSA clinical classification.

45% of the infections were monomicrobial (typically with gram-positive cocci), but we also found gram-negative rods and enterococci. Initial therapy was usually empiric, while definitive therapy is based on the results of culture and sensitivity tests, as well as the clinical response to empiric therapy.

The effectiveness of the antibiotic therapy, based on the clinical evolution and the absence of surgical intervention is related to the presence or absence of ischaemia and other diabetes-related complications rather than to the microorganism itself; antibiotics are a crucially important adjunct in the complex therapy of the diabetic foot.