SHM's Clinical Quick Talks-Empiric Management of a Diabetic Foot Infection

Pdf Summary

Diabetic foot infections (DFIs) are a frequent complication of diabetes, often resulting in hospitalization with significant health risks. The most common cause is a break in the skin, typically from a diabetic foot ulcer (DFU). These ulcers are more prevalent in individuals with peripheral neuropathy and peripheral artery disease (PAD), which can impair wound healing due to poor vascular supply. DFIs are diagnosed based on clinical signs of inflammation and confirmed through laboratory and microbiologic assessments, including deep wound cultures and imaging for bone involvement. Hospitalization is recommended for severe cases with systemic symptoms or specific wound characteristics like abscesses and necrosis. Empiric antibiotic regimens should target common pathogens like S. aureus, streptococci, and possibly MRSA or gram-negative bacteria in severe infections. Complications such as osteomyelitis, necrotizing fasciitis, and limb ischemia can occur and require urgent management. It is essential to differentiate colonization from infection, conduct thorough evaluations, and consider potential complications during the treatment of DFIs. The document also provides guidelines for antibiotic therapy based on infection severity. Regular screening for complications is crucial for proper management of diabetic foot infections.

Asset Subtitle

Kathryn Haroldson, Andrew Robinson

Keywords

Diabetic foot infections

DFIs

Diabetes complications

Hospitalization risks

Diabetic foot ulcers

Peripheral neuropathy

Peripheral artery disease

Wound healing impairment

Empiric antibiotic regimens

Osteomyelitis complications