GuidelinesOther guideline
Diabetic Foot
Infection Diabetic foot Brief outline/clinical setting Foot wound with the presence of at least two signs of inflammation (erythema, warmth, tenderness, pain, or induration) or purulent secretions. Mild: Local infection involving only the skin and the subcutaneous tissue, if erythema: ≤2cm around ulcer Moderate: As above, erythema >2cm or involving structures deeper than skin and subcutaneous
| Infection | Diabetic foot |
| Brief outline/clinical setting | Foot wound with the presence of at least two signs of inflammation (erythema, warmth, tenderness, pain, or induration) or purulent secretions. Mild: Local infection involving only the skin and the subcutaneous tissue, if erythema: ≤2cm around ulcer Moderate: As above, erythema >2cm or involving structures deeper than skin and subcutaneous tissues, NO systemic inflammatory response Severe: As above, but with signs of SIRS Definitive therapy should be based on cultures of infected tissue. |
| Aetiologies/organisms | Streptococci, S. aureus Chronic / previously treated: in addition to above, Enterobacterales, anaerobes, enterococci, pseudomonas |
| Optimal antimicrobial selection | Mild / moderate: flucloxacillin 500mg 6 hourly po, amoxicillin- clavulanate 1g 12 hourly po Severe: amoxicillin- clavulanate 1.2g 8 hourly IVI If pseudomonas suspected: piperacillin-tazobactam 4.5g 8 hourly IVI |
| Duration | 7 – 14 days. May extend to 2 – 4 weeks if adequate source control problematic |
| Alternative if allergic/not available | Mild/moderate: clindamycin 450mg 8 hourly po Severe: clindamycin 600mg 8 hourly IVI PLUS ciprofloxacin 400mg 8 hourly IVI |
| Rationale | |
| Level of evidence | Guidelines (Strong recommendation, low quality evidence) |
| Link to Guideline | Click here |