Objective: To determine the treatment of foot infections in patients with diabetes mellitus and the implementation of the Dutch consensus guidelines.
Design: Questionnaire.
Setting: Nationwide.
Method: To 180 internists and paediatricians were sent a letter explaining the objective of the survey and a questionnaire. After two months an identical questionnaire was sent, with the request to return it when the first questionnaire had not been returned yet.
Results: Seventy-three questionnaires (40%) were returned of which 63 were evaluable. The main reason for hospitalisation was the threat of limb loss (90%). Most patients presenting with superficial wound infections were treated with local surgical procedures (90%); however, 16% of the responders considered hospitalisation indicated. If osteomyelitis was present 81% of the responders would hospitalize the patient. Antibiotic treatment was instituted by 93%. In all, 11 different antibiotics were used. Of antibiotic combinations the combination of penicillin and lincomycin was used most frequently and the recommended combination of aminoglycoside and lincomycin least. The main reason for using a combination of antibiotics was presence of polymicrobial flora (93%).
Conclusion: We conclude that treatment of diabetic foot is still very diverse in spite of the consensus guidelines.
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