Diabetes mellitus and its associated complications cause significant morbidity and mortality, have a negative impact on quality of life, and lead to substantial costs for the health care system.. The prevalence of diabetes worldwide is projected to reach 300 million people by the year 2025. In Canada, more than 2 million people are living with diabetes, and this number is expected to increase to 3 million by 2010. In 1998, the estimated total economic burden of diabetes in Canada was reported to range from US$4.76 billion to US$5.23 billion. These values would translate to $7.04 billion to $7.74 billion in Canadian dollars, given the mean exchange rate of Can$1.48 = US$1 in 1998. If these values are projected to 2007, the total economic burden would be approximately Can$9.25 billion to Can$10.2 billion. However, extrapolation of 1998 results to the present would likely result in an underestimation of costs. In a more recent report, the Canadian Diabetes Association estimated, using data from a US study, that diabetes and its complications cost Canada’s health care system Can$13.2 billion annually. This value was projected to increase to Can$15.6 billion/year by 2010 and to Can$19.2 billion/ year by 2020.
In addition to the increasing prevalence and economic burden of this disease, patients with diabetes face numerous complications throughout their lifetime. One common complication is foot ulceration, leading to infection and amputation. The annual incidence of foot ulceration ranges from 1% to 4%, and the lifetime risk may range from 15% to 25%. With ulceration, tissues are exposed to bacterial colonization, which can eventually progress to infection. Staphylococcus aureus and Streptococcus spp. are the predominant microorganisms that colonize tissues and cause acute infections in previously untreated patients. In patients with chronic wounds or infections involving deep tissues, gram- negative bacilli, enterococci, and anaerobic species may become important pathogens. suhagra
Clinicians face many challenges in the treatment of diabetic foot infections, especially in the choice of antibiotic regimen. The guidelines of the Infectious Diseases Society of America (IDSA) can guide clinicians in choosing empiric antibiotic regimens, but they provide no recommendations on specific antibiotic regimens, because of the poor quality of data available in the literature. Given this lack of direction, management of diabetic foot infections is often suboptimal or inadequate.