Foot
infections are a major cause of morbidity in diabetic patients. Staphylococcus aureus is the most important pathogen in mild
infections; moderate to severe
infections are frequently polymicrobial. Multidrug resistance is an increasing problem in isolates from
diabetic feet. Worldwide, up to 30% of patients with
diabetic foot infection (DFI) are colonised with methicillin-resistant S. aureus (MRSA), whilst extended-spectrum
beta-lactamase-producing Gram-negative bacteria are also common in some countries. This emergence of drug resistance has coincided with the launch or imminent availability of many new
antibiotics. Most of these were developed to target multidrug-resistant Gram-positive bacteria, although some have a spectrum of activity that includes Gram-negative bacteria and anaerobes. There is a variable amount of experience with these agents in treating skin and skin-structure
infections (SSSIs), especially for DFI. However, at least some have a spectrum of activity and/or pharmacological properties that suggest that they may be of value in managing DFIs. The aim of this paper is to review evidence for the efficacy of new
antibiotics in the management of SSSIs, including any data relating specifically to the
diabetic foot, and to consider where they might fit into the therapeutic armory against DFI.