{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:34:44Z","timestamp":1765485284446},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2008,6,5]],"date-time":"2008-06-05T00:00:00Z","timestamp":1212624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2008,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold> To conduct a multicentre observational study to describe management of foot infections in diabetes in the out\u2010patient setting in Italy.<\/jats:p><jats:p><jats:bold>Patients and methods\u2003<\/jats:bold> Ten centres equally distributed nationwide were asked to collect, by means of a spreadsheet (Access\/Excel Microsoft program), data concerning 30 consecutive diabetic patients with foot infections deemed suitable for antibiotic treatment in the out\u2010patient setting. Centres with \u2265\u00a05\u00a0years\u2019 experience of out\u2010patient management were selected. Data from 271 consecutive patients treated as out\u2010patients were collected and analysed by the central coordinator. Statistical analysis was performed using the SPSS statistical software package.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> Lesions were mainly located at the toes and midfoot (33.6 and 30.2%, respectively); 63 (23.2%) patients had multiple ulcers. Seventy (25.8%) patients also had concomitant osteomyelitis. Three hundred and four pathogens, including Gram\u2010positive and Gram\u2010negative aerobes and anaerobes, were isolated in 219\/271 patients (80.8%) by culturing debrided tissue (71.2%) or purulent material (28.8%). Infections were polymicrobial in 33.8% of patients. The most common pathogens were <jats:italic>Staphylococcus aureus<\/jats:italic> (27.3%) and <jats:italic>Pseudomonas <\/jats:italic>spp. (20.4%); enterobacteriaceae, enterococci, streptococci and anaerobes accounted for 11.5, 7.6, 6.9 and 1.9%, respectively. Antibiotics were frequently administered by parenteral route and frequently in combination. Piperacillin\/tazobactam was the parenteral antibiotic most frequently utilized (21.1%). Cure\/improvement was observed in 93.4% of patients.<\/jats:p><jats:p><jats:bold>Conclusions\u2003<\/jats:bold> Foot ulcers in diabetes are common and serious; the aetiology is often polymicrobial, often including <jats:italic>S. aureus<\/jats:italic> and <jats:italic>Pseudomonas<\/jats:italic> spp. Treatment in the out\u2010patient setting is safe and effective, and penicillins together with \u03b2\u2010lactamase inhibitors and fluoroquinolones are the most frequent choice.<\/jats:p>","DOI":"10.1111\/j.1464-5491.2008.02507.x","type":"journal-article","created":{"date-parts":[[2008,6,5]],"date-time":"2008-06-05T07:39:13Z","timestamp":1212651553000},"page":"979-984","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Foot infections in diabetes (DFIs) in the out\u2010patient setting: an Italian multicentre observational survey"],"prefix":"10.1111","volume":"25","author":[{"given":"S.","family":"Esposito","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Leone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Noviello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Fiore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Ianniello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. M.","family":"Felaco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Romagnoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Sarli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,7,28]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/047086138X"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/380449"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkh531"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67694-5"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm130"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/clind\/24.4.643"},{"key":"e_1_2_8_9_2","first-page":"230","article-title":"Outpatient Parenteral Antibiotic Therapy (OPAT) of diabetic foot infections with piperacillin\/tazobactam","volume":"10","author":"Marvaso A","year":"2002","journal-title":"Infez Med"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009143431107"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/424846"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(99)80085-4"},{"key":"e_1_2_8_13_2","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.1001\/archinte.1996.00440190131013","article-title":"The acutely infected diabetic foot is not adequately evaluated in an inpatient setting","volume":"156","author":"Edelson GW","year":"1996","journal-title":"Arch Intern Med"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.453"},{"key":"e_1_2_8_15_2","unstructured":"World Health Organization Expert Committee.Definition diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation part I: Diagnosis and Classification of Diabetes Mellitus. Geneva:World Health Organization 1999."},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(96)80125-6"},{"key":"e_1_2_8_17_2","first-page":"109","article-title":"Anatomic location of acute diabetic foot infection. Its influence on the outcome of treatment","volume":"53","author":"Kaufman J","year":"1987","journal-title":"Am Surg"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1086\/516148"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2425"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1990.00390160058013"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2006.00274.x"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90388-2"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/6.Supplement_1.S171"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2002.00696_1.x"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/1.1.210"},{"key":"e_1_2_8_26_2","first-page":"149","article-title":"Bacteriology of diabetic foot ulcers","volume":"23","author":"Sims D","year":"1984","journal-title":"J Foot Surg"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1086\/516184"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1986.00360220079017"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2004.06.001"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(03)00300-3"},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2005.06.016"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199957050-00017"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/37.2.285"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(97)00160-0"},{"key":"e_1_2_8_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0732-8893(98)00004-2"},{"key":"e_1_2_8_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079801900311"},{"key":"e_1_2_8_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(02)85005-6"},{"key":"e_1_2_8_38_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2005.6.27"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1464-5491.2008.02507.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1464-5491.2008.02507.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T10:52:57Z","timestamp":1696935177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1464-5491.2008.02507.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,28]]},"references-count":37,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2008,8]]}},"alternative-id":["10.1111\/j.1464-5491.2008.02507.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1464-5491.2008.02507.x","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,28]]},"assertion":[{"value":"2008-07-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}