For people with diabetes, lower extremity complications are particularly common and problematic. Indeed, foot infection is the most common reason for hospital admission for people with diabetes. Without proper evaluation and treatment, diabetic foot infections can have severe ramifications and may potentially lead to amputation and death. Given the increasing prevalence of diabetes, it is essential to have a strong awareness and understanding of the emerging studies on diabetic foot infections, and the potential impact of these studies on clinical practice.
With these points in mind, we convened a roundtable discussion with some of the most prominent authorities in the care of diabetic foot infections.
We proceeded to take a closer look at the findings from the recent SIDESTEP study, which is currently the largest published study of diabetic foot infections. The panelists discussed the design of the randomized, double-blinded, multicenter trial and key factors in the protocol that played a role in the clinical outcomes we saw with this study. We also discussed how these clinical outcomes may affect one’s decision-making in regard to the antibiotic treatment regimen for patients with diabetic foot infections.
|  | | “Hopefully, the commentary on the emerging research will be beneficial for all clinicians who treat diabetic foot infections.”
– Dr. Armstrong |
Given the ongoing problem of antibiotic resistance, the panelists emphasized the importance of appropriate antibiotic selection. Accordingly, we discussed similarities and differences in the spectrum of activity for ertapenem and piperacillin/tazobactam, the two antibiotics that were assessed in the SIDESTEP study. The panelists also explored the issue of appropriate culturing of diabetic foot wounds.
Expounding upon the findings of the SIDESTEP study, the panelists discussed the prevailing thinking on the etiology of diabetic foot infections, and how the thinking on these pathogens has changed and evolved over the years. In addition to this provocative commentary, the panelists also discussed whether there is a need for specific anti-MRSA therapy.
The panelists concluded this thought-provoking discussion by touching upon other areas of interest, including potential risk factors for treatment failure and pharmacoeconomic data, that may be explored in future publications that emerge from the SIDESTEP study.
I would like to thank the doctors who shared their insights during this forum. I would also like to acknowledge Merck for its unrestricted support of this discussion. Hopefully, the perspectives and commentary on the emerging research will be beneficial for all clinicians who treat diabetic foot infections.
— David G. Armstrong, DPM, PhD |
