Managing foot infections in patients with diabetes

Abstract

Foot infections are a significant cause of morbidity for patients with diabetes and if left untreated can lead to amputation. Patients need to be instructed to wash, dry and examine their feet daily and are encouraged to seek medical attention promptly if they see signs of foot infection or new ulcer formation. Empirical use of antibiotics will often be necessary while awaiting the results of bacteriological and imaging investigations. When in doubt about the severity of infection urgent referral to a surgeon or specialist foot service for a second opinion is advised. Hospitalisation for observation, parenteral antibiotic therapy and possible surgical intervention may also be necessary. Diabetic arthropathy needs to be considered when signs mimicking infection are present in the absence of ulceration. Osteomyelitis or plantar space infection should be excluded as complicating factors if there is not rapid clinical improvement after starting antibiotic therapy.