Diabetic foot infections cause substantial morbidity, incur significant costs, and may lead to amputation. Resistant organisms,
particularly methicillin-resistant
Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative organisms, are becoming more prevalent. Optimal management of diabetic foot
infections is multimodal, and includes not only antimicrobial therapy but also biomechanical support and offloading, local
wound care, glycemic control, assessment and treatment of underlying vascular disease, and surgical therapy when warranted.
Antimicrobial therapy should be targeted at the likely etiologic agents and should take into consideration the depth and severity
of infection. With expansion of the reservoir of resistant organisms, obtaining reliable deep cultures can help focus antimicrobial
therapy against the dominant pathogens. Newer agents against resistant gram-positive and gramnegative organisms show promise
in the treatment of diabetic foot infections.