[Microbiology of diabetic foot infections: role of ertapenem].

Many patients with diabetes develop foot ulcers that are very susceptible to infections which may place the patients at risk for lower-limb amputation. Such infections require adequate management with antibiotics. The authors performed a systematic analysis and critical review of studies with the dual aim of assessing bacterial profiles and antimicrobial susceptibility patterns in patients with diabetic foot infections using various methods for sample collection and evaluating the safety and efficacy of ertapenem as initial empirical treatment for such infections. Following a selection of only studies with adequate description of methods for pathogen isolation and antibiogram determination, nine studies were included. The need for adequate prospective multicenter studies to assess the value of empirical antibiotic regimens for diabetic foot became evident and the conclusions were as follows: proper identification of causative agents, appropriate antibiotic therapy and management of complications in these infections are essential to achieve a successful outcome; the sampling procedure is extremely important in the evaluation of the microbial flora of the foot ulcer; susceptibility testing should be performed routinely at least for those species with unpredictable resistance; and ertapenem has been shown to be useful in the treatment of a wide range of moderate-to-severe lower extremity infections in a broad spectrum of patients.