Guidelines
Diabetic Foot Infection

Diabetic Foot Infection

Cultures / Microbiology

  • Obtain an appropriate specimen for culture from almost all infected wounds
  • Cleanse and debride the wound before obtaining specimen(s) for culture
  • Do Not
    • Culture a wound that appears uninfected
    • Swab the wound to obtain a culture
    • Culture without first cleaning and debriding a wound

Definitions

Mild: no signs of systemic infection plus at least two of the following:

  • swelling/induration
  • erythema ≤ 2 cm around ulcer
  • tenderness/pain
  • warmth
  • purulent drainage

Moderate: Local infection with erythema > 2 cm or that may involve deep tissues and ≤ 1 sign of SIRS

Severe: Local infection with erythema >2 cm or that may involve deep tissues and at least one of the following:

  • ≥ 2 signs of SIRS
  • hemodynamic instability
  • patient is immunocompromised

Outpatient Treatment Regimens

Inpatient Treatment Regimens

More Information

Last Updated: 5.25.21

  1. Benjamin A, et al. 2012 IDSA Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections, CID, Volume 54, Issue 12, 15 June 2012, Pages e132–e173
  2. Diabetes Canada Clinical Practice Guidelines Expert Committee, Embil JM, Albalawi Z, Bowering K, Trepman E. Foot Care. Can J Diabetes. 2018 Apr;42 Suppl 1:S222-S227
  3. Weintrob AC. Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities. In: UpToDate, Calderwood, SB (Ed), UpToDate, Waltham, MA. (Accessed on Apr 22, 2021.)