Infect Chemother.  2018 Mar;50(1):11-20. 10.3947/ic.2018.50.1.11.

Microbiology and Antimicrobial Therapy for Diabetic Foot Infections

• Kwon KT
• Armstrong

• KMID: 2407963
• DOI: http://doi.org/10.3947/ic.2018.50.1.11

Abstract

In addition to being the prime factor associated with amputation, diabetic foot infections (DFIs) are associated with major morbidity, increasing mortality, and reduced quality of life. The choice of appropriate antibiotics is very important in order to reduce treatment failure, antimicrobial resistance, adverse events, and costs. We reviewed articles on microbiology and antimicrobial therapy and discuss antibiotic selection in Korean patients with DFIs. Similar to Western countries, Staphylococcus aureus is the most common pathogen, with Streptococcus, Enterococcus, Enterobacteriaceae and Pseudomonas also prevalent in Korea. It is recommended that antibiotics are not prescribed for clinically uninfected wounds and that empirical antibiotics be selected based on the clinical features, disease severity, and local antimicrobial resistance patterns. Narrow-spectrum oral antibiotics can be administered for mild infections and broad-spectrum parenteral antibiotics should be administered for some moderate and severe infections. In cases with risk factors for methicillin-resistant S. aureus or Pseudomonas, empirical antibiotics to cover each pathogen should be considered. The Health Insurance Review and Assessment Service standards should also be considered when choosing empirical antibiotics. In Korea, nationwide studies need to be conducted and DFI guidelines should be developed.

Keyword

Diabetic foot; Infections; Microbiology; Antibiotics

MeSH Terms

Amputation
Anti-Bacterial Agents
Diabetic Foot*
Enterobacteriaceae
Enterococcus
Humans
Insurance, Health
Korea
Methicillin Resistance
Mortality
Pseudomonas
Quality of Life
Risk Factors
Staphylococcus aureus
Streptococcus
Treatment Failure
Wounds and Injuries
Anti-Bacterial Agents

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