Guidelines For Clinical Practice
Copyright ©2011 Baishideng Publishing Group Co.
World J Diabetes. Feb 15, 2011; 2(2): 24-32
Published online Feb 15, 2011. doi: 10.4239/wjd.v2.i2.24
Table 2 Factors to be considered for antibiotic prescription in diabetic foot infection (adapted from reference [17])
Severity of infectionBroad-spectrum therapy via parenteral route for severe infection
Renal dysfunctionAvoid nephrotoxic agents (aminoglycosides, glycopeptides)
Hepatic dysfunctionAvoid hepatotoxic agents (macrolides, amoxicillin/clavulanate)
Ischemic limbUse relatively high doses of oral antibiotics or prefer IV route to achieve adequate antibiotic level at the site of infection if revascularization procedure is unfeasible
Consider anti-anaerobic bacteria when there is ischaemia or extensive devitalized tissue
Impaired gastrointestinal function (gastroparesis)Prefer parenteral route
Local antibiotic resistance patternsCover MRSA if indicated
Drug allergiesReview patient's medical history carefully
History of recent antibiotic treatmentMay need an extended coverage against gram-negative bacilli and Enterococcus
Chronicity of the woundGive preference to broad-spectrum therapy initially
Poor therapeutic complianceConsider IV route and/or hospitalization