Principles of antibiotic treatment

• The microbiology of the diabetic foot is unique. Infection can be caused by Gram-positive aerobic, and Gram-negative aerobic and anaerobic bacteria, singly or in combination (Table 5.1)

• As there may be a poor immune response of the diabetic patient, even bacteria normally regarded as skin commensals may cause severe tissue damage. This includes Gram-negative organisms such as Citrobacter, Serratia, Pseudomonas and Acinetobacter. When Gram-negative

Table 5.1 Bacteria isolated from the diabetic foot

Gram positive

Gram negative

Staphylococcus aureus



Escherichia coli



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