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Diabetic foot infection – quick review chart

Consider infection with bacteria if atleast 2 of
 local erythema or induration erythema local tenderness or pain local warmth purulent discharge.

 

severity of infection risk of complications previous microbiology results previous antibiotic use patient preference

 

Prescribing antibiotic – children and young people < 18 seek specialist adv use oral route 1st line unless it cannot be used or severity of the condition necessitates IV route ( review within 48 hrs if IV route used & consider switching to oral route if possible ) a longer than 7 day course may be needed based on clinical assessment skin takes some time to return to normal and a complete resolution of symptoms at 7 days is not expected

 

Advice and follow up – render worsening advice review choice of antibiotic when microbiology results ready reassess if symptoms do not improve within 1-2 days or worsen 
( for e.g pain out of proportion to infection ) significantly and consider aspects as
○ ? alternative diagnosis as pressure sores , gout or non-infected ulcer
○ a more serious illness as limb ischaemia , osteomyelitis , necrotizing fasciitis or sepsis ?

REFERENCE NICE guideline 19 Diabetic foot problems: prevention and management Recommendations | Diabetic foot problems: prevention and management | Guidance | NICE

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