[Management of diabetic foot infections]

All infected diabetic foot wounds require antibiotic treatment. Antibiotic treatment is influenced by the patient's features as the vascular status, the leukocyte function and the kidney activity. The initial antibiotic regimen is usually chosen empirically and it can be modified on the basis of the microbiological information obtained subsequently. The initial empiric therapy should be based, on one hand, on the grade of infected lesion and, secondly, on the epidemiological data. Almost all of the mild/moderate infected wounds can be treated with antibiotics with a spectrum of activity limited to Gram-positive cocci. Treatment with oral antibiotics is sufficient in most cases in patients with mild/moderate infections. With severe infections is more appropriate to use a broad-spectrum antibiotic therapy. Furthermore it is safer to start a parenteral therapy, possibly modifying it into an oral administration if the patient has stabilized. The most frequently pathogen observed in diabetic foot infections is Staphylococcus aureus. It is important to understand whether there are elements that may lead to the suspicion of MRSA infection in order to establish an appropriate antimicrobial therapy.