Detection, management, and prevention of diabetes-related foot disease in the Australian context

Table 2 Common bacteria involved in diabetic foot infections according to infection grade, adapted from the International Working Group on the Diabetic Foot infection guidelines[47]

IWGDF classification	Recommended empirical cover
	Gram-positive (MSSA, Streptococcus spp.)	Gram-negative (enteric, non-pseudomonal)	Obligate anaerobes	MRSA	Pseudomonal
Mild (grade 2) – no recent antibiotics	Yes	No	No	If at risk1	No
Mild (grade 2) – recent antibiotics or water-immersed wound	Yes	Yes	Consider if chronic	If at risk1	No
Moderate (grade 3)	Yes	Yes	Consider	If at risk1	Tropical climates or recently cultured
Severe (grade 4)	Yes	Yes	Yes	If at risk1	Yes

¹Risk factors for methicillin-resistant Staphylococcus aureus (MRSA) include previous colonisation with MRSA, residence in a community, aged-care facility, or correctional facility with high MRSA prevalence, and frequent or prolonged stay in a hospital with a high prevalence of MRSA.

IWGDF: International Working Group on the Diabetic Foot; MSSA: Methicillin-susceptible Staphylococcus aureus; MRSA: Methicillin-resistant Staphylococcus aureus.