Antibiotic choice for moderate infection of diabetes-related foot ulcers

For management considerations including the role of surgery, see Approach to managing infection of diabetes-related foot ulcers.

Oral antibiotic therapy is appropriate for patients with moderate infection of a diabetes-related foot ulcer whoCommons, 2021Cortes-Penfield, 2023:

• are systemically well
• are able to tolerate and absorb oral therapy
• have probable bone or joint infection (osteomyelitis or septic arthritis) of the forefoot (toes and metatarsals) with limited soft tissue involvement.

Initial intravenous therapy is required for patients who do not meet these criteria.

Empirical antibiotic therapy with activity against methicillin-resistant Staphylococcus aureus (MRSA) is required for patients who are at increased risk of MRSA infectionCommons, 2021Hand, 2019.

If Pseudomonas aeruginosa infection is suspected (eg recent colonisation or infection with P. aeruginosa, penetrating injury through footwear), see Empirical therapy for severe infection of diabetes-related foot ulcers.