Table 1.

Suggested antibiotics for the empirical treatment of infected DFUs based on the clinical severity. Adapted from Lipsky et al. [80].

Severity	Associated Pathogen(s)	Additional Factor(s)	Antibiotic(s)
Mild (topical or oral antibacterial agents)	Staphylococcus aureus (MSSA) Streptococcus spp.	No complicating features	First-generation cephalosporin, nafcillin, ampicillin/sulbactam, amoxicillin/clavulanate, clindamycin
		β-lactam allergy or intolerance	Clindamycin, levofloxacin, moxifloxacin, doxycycline
		Recent antibiotic exposure	Levofloxacin, moxifloxacin, second- or third-generation cephalosporin
	MRSA		Clindamycin, doxycycline, trimethoprim/sulfamethoxazole
Moderate (oral or initial parenteral antibacterial agents) or Severe (parenteral antibacterial agents)	MSSA Streptococcus spp. Enterobacteriaceae obligate anaerobes	No complicating features	Second- or third-generation cephalosporin, aminoglycoside
		Recent antibiotic exposure	Third-generation cephalosporin, aminoglycoside, ertapenem, piperacillin/tazobactam, cefepime
	Pseudomonas aeruginosa		Piperacillin/tazobactam, cefepime, imipenem, meropenem
	MRSA Enterobacteriaceae obligate anaerobes		Vancomycinc plus one of the following: ceftazidime, cefepime, piperacillin/tazobactam, aztreonam, or a carbapenem
	ESBL, MDR Gram-negative		Piperacillin/tazobactam plus one of the following: aminoglycoside, or a carbapenem