Antibiotic Therapy in the Diabetic Foot

Empiric antimicrobial therapy for diabetic foot infections must be selected with attention to wound severity and patient-specific factors including comorbidities, antibiotic allergies, prior cultures, risk factors for antibiotic-resistant organisms and the local antibiogram. Subsequent therapy can be tailored in spectrum by culture results and its duration informed by surgical approach and pathologic data. After initial clinical improvement, most patients can be transitioned to oral step-down therapy. The duration of treatment for soft tissue infection (STI) is based on the severity of STI and when osteomyelitis is present, whether surgical resection of the involved bone has been performed.