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Pharmacotherapy of Diabetic Foot Ulcers

Sparrow Hospital, Department of Pharmacy, 1215 East Michigan Avenue, Lansing, MI 48912.smithc{at}ferris.edu

The incidence of diabetes and diabetic foot ulcers is increasing significantly in the United States. These ulcers and infections are the result of long-term complications of diabetes including neuropathy and vascular insufficiency. These infections can be classified into mild, limb threatening, and life threatening. This classification helps clarify the expected organisms involved and consequently appropriate, empiric antibiotic therapy. Mild infections are generally caused by Gram-positive organisms and can usually be treated as an outpatient with oral antibiotics. Antibiotics used for mild infections-include cephalexin, clindamycin, and amoxicillin/ clavulanate. Moderate to severe or limb-threatening infections are usually polymicrobial and frequently require hospitalization. These infections are typically treated with more broad-spectrum antibiotics including ampicillin/sulbactam, imipenem, or the combination of clindamycin and a fluoroquinolone. Severe or life-threatening infections also require broad-spectrum antibiotics. Other therapeutic options besides antibiotics include growth factors, such as becaplermin, and various skin substitutes.

Key Words: Diabetes • foot • ulcers • infection • antibiotics

Journal of Pharmacy Practice, Vol. 17, No. 1, 66-74 (2004)
DOI: 10.1177/0897190003261311


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