title: Current medical management of diabetic foot infections.
abstract: Foot infections are a serious complication of diabetes associated with substantial morbidity and occasional mortality. Antibiotic therapy for mild infections in patients who have not recently received antibiotic therapy can often be directed at just staphylococci and streptococci. Empiric therapy for infections that are chronic, moderate or severe, or that occur in patients who have failed previous antibiotic treatment, should usually be more broad spectrum. Bone infection also complicates a substantial percentage of diabetic foot wounds and increases the likelihood of treatment failure, requiring lower extremity amputation. An increasing body of evidence supports the effectiveness of nonsurgical treatment of diabetic foot osteomyelitis in selected patients, although the optimal choice of agent, route of administration and duration of therapy have yet to be defined. This article examines the potential role of standard and newer antibiotics that may be appropriate for treating diabetic foot infections, including ertapenem, vancomycin, moxifloxacin, daptomycin, telavancin and tigecycline, as well as several investigational agents, such as dalbavancin, ceftobiprole and nemonoxacin.
authors.affiliation: Division of Medical Sciences, New York College of Podiatric Medicine, 53 East 124th Street, New York, NY 10035, USA. mkosins@nycpm.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Kosinski
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lipsky
mesh_terms: D000671:Amputation, Surgical; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D017719:Diabetic Foot / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D010019:Osteomyelitis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents