Diabetic Foot Infection: Antimicrobial Prescribing

Background In diabetes, all foot wounds are likely to be colonised with bacteria Diabetic foot infection has at least 2 of:
• local swelling or induration
• erythema
• local tenderness or pain
• local warmth
• purulent discharge

Severity is classified as:
• Mild - local infection with 0.5 to less than 2 cm erythema
• Moderate - local infection with more than 2 cm erythema or involving deeper structures (such as abscess, osteomyelitis, septic arthritis or fasciitis)
• Severe - local infection with signs of a systemic inflammatory response
Prescribing considerations
When choosing an antibiotic, take account of:
• the severity of infection (mild, moderate or severe)
• the risk of complications
• previous microbiological results
• previous antibiotic use
• patient preference
Give oral antibiotics first line if possible Review intravenous antibiotics by 48 hours and consider switching to oral antibiotics if possible Review need for continued antibiotics regularly

