Among diabetics, infections of the feet are common, and are a leading cause of hospitalization. An estimated 15% of people with diabetes will suffer from a diabetic foot ulcer. Antibiotics are frequently prescribed to treat this condition, which often leads to lengthy hospitalization, disability and amputations. A startling 85% of diabetes-related amputations in the lower extremities are caused by foot ulcers, and 1 in 5 hospital visits by diabetics are because of foot ulcers. This is often caused by nerve damage, due to high blood sugar. The solution lies in prevention, accurate diagnosis and proper treatment. In the case of the diabetic foot ulcer and antibiotics, these powerful drugs are necessary for effective treatment, but care must be taken, as overuse of antibiotics for diabetic foot infections can cause antibiotic resistance, whereby the bacteria become immune and the medicine no longer works.
Diabetic Foot Infection and Antibiotics: Correct Treatment Begins with Accurate Evaluation
Proper treatment begins with a complete evaluation of the diabetic foot ulcer. Antibiotics should not be indiscriminately prescribed. Foot ulcers can be neuropathic (relating to nerve damage) or vascular (relating to the blood vessels). Cultures should be taken from any infected wounds, and a bone biopsy may be necessary. Treatment of foot ulcers include debridement (cleaning the wound and applying a cleanser and dressing), offloading (taking pressure off the affected area), and infection control with antibiotics. There is a link between the severity of the diabetic foot ulcer and antibiotics. According to GlobalRPh.com (an online clinician’s reference guide), specific drugs are used for different levels of infection. For a mild diabetic foot ulcer, antibiotics that are recommended include cephalexin, dicloxacillin, augmentin and clindamycin. A more serious infection requires hospital care with oral antibiotics and if the situation worsens, intravenous. The most serious case, where there is anaerobic bacteria and possibly gangrene, requires hospitalization and combined intravenous antibiotics, possibly clindamycin and ciprofloxacin or tobramycin.
Information for the Diabetic: Antibiotics and Safety, and Prevention of Foot Ulcers
There are preventative measures you can take to care for your feet, to avoid the risk of amputation and to also avoid the need of antibiotics, as antibiotics are not without risks. Some people may have allergic reactions (sometimes severe), there may be digestive disorders, sunlight sensitivity, or even a risk of developing kidney stones or a blood clot (though rare). Also, bacteria will build up a resistance to the antibiotics over time, creating “super bugs” that become more difficult to obliterate. A look at the risk factors for ulcers gives a strong indication of how they can be prevented – nerve damage, improperly fitted shoes, limited joint mobility, renal disease, uncontrolled hyperglycemia and duration of diabetes. By managing your diabetes with weight loss, a healthy diet, exercise, and by carefully monitoring your blood sugar, you keep your entire body healthy – and that includes your feet.
