Initial antibiotic therapy for postoperative moderate or severe diabetic foot infections: Broad versus narrow spectrum, empirical versus targeted
Authors' conclusion
In this study, the microbiological adequacy of the initial antibiotic regimen after (surgical) debridement for DFI did not alter therapeutic outcomes. We recommend that clinicians follow the stewardship approach of avoiding antibiotic de-escalation and start with a narrow-spectrum regimen based on the local epidemiology.
Study context
- Population
- Patients with moderate or severe DFI undergoing surgical debridement, including partial amputationsDFI episodes in 332 patients
- Participants
- 716 DFI episodes
- Exposure
- Adequate empirical vs culture-guided vs empirical inadequate switched to targeted initial postoperative antibiotic therapy
- Adequate empirical therapyn = 194
- Culture-guided therapyn = 291
- Empirical inadequate therapyn = 231
- Outcome
- Rate of ultimate therapeutic failures
Main finding
As reported in the abstract
Clinical failure
Observational data: associations, not effects.
Further findings
Broad- vs narrow-spectrum antibiotic choice
- A broad-spectrum antibiotic choice could not alter the failure risk
Original publication
Initial antibiotic therapy for postoperative moderate or severe diabetic foot infections: Broad versus narrow spectrum, empirical versus targeted. Diabetes Obes Metab. Published 2 August 2023. doi:10.
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