Diabetic ulcers--a clinical and bacteriological study

In an 8 month period we have studied 100 consecutive patients with diabetic ulcers. The sex distribution was even. Eighty-three percent had non-insulin dependent diabetes mellitus. Sixty-nine percent of the ulcers were gangrenous as opposed to neuropathic and over half the ulcers involved the big toes. Osteomyclitis was seen in 44% of the patients. Staphylococcus aureus and Escherichia coli were the commonest infecting organisms at initial cultures and at repeat cultures 4 weeks later. Amoxicillin plus clavulinic acid (Augmentin) and Clindamycin were the best antimicrobial combinations in cases where the ulcers had some acute features (e.g. surrounding cellulitis).