The diabetic foot ulcers: anti-infectious strategies

Infection is a common problem in diabetic patients vith foot ulcers. The diagnosis of infection is not always easy to establish, but must be made for proper therapeutic decision making. In addition to local care, search for arteriopathy and strict control of blood glucose, treatment of infected foot ulcers requires an appropriate anti-infectious strategy. We developed diagnostic and therapeutic decisional algorithms from data available in the literature in order to establish a management strategy for different clinical situations. The fundamental role of clinical assessment is underlined and the different causal microorganisms are recalled, together with the anti-microbial activity and bone concentrations of the main antibiotics used. An optimal anti-infection work-up can undoubtedly significantly reduce the number of amputations in diabetic patients.