Diagnosis and Management of Diabetic Foot Infection*

According to the American Diabetes Association, approximately 82 000 nontraumatic lower-limb amputations were performed among people with diabetes in the United States in 2002. Guidelines on managing the patient with diabetes with suspected or evident foot infection, prepared by members of the Infectious Diseases Society of America, were published recently. This article reviews the information from those guidelines focusing on the workup and treatment of a patient with diabetic foot infection. Optimal management of diabetic foot infections requires appropriate culture (ie, after the wound has been cleaned, and from the deepest site possible) and appropriate antibiotic (ie, empirically covering for Staphylococcus and Streptococcus for mild infections and covering aerobic and anaerobic organisms in patients with moderate to severe infections). If hospitalization is required, timely surgical consultation and intervention is critical. Surgical consultation should involve surgeons experienced with diabetic foot complications. (Adv Stud Med. 2006;6(6C):S549-S554) F oot infections in persons with diabetes are common and costly. They account for the largest number of diabetes-related hospital bed days. They are also the most common cause of nontraumatic leg amputations. According to the American Diabetes Association, approximately 82 000 nontraumatic lower-limb amputations were performed among people with diabetes in the United States in 2002. The risk of a leg amputation—the most severe and permanent local morbidity of diabetic foot infection—is 15 to 40 times greater for a person with diabetes than the general population.