Diabetes and acute bacterial skin and skin structure infections

Marco Falcone, Juris J. Meier, Maria Giulia Marini, Riccardo Caccialanza, José María Aguado, Stefano Del Prato, Francesco Menichetti

Research output: Contribution to journalReview articlepeer-review

Abstract

Acute bacterial skin and skin structures infections (ABSSSIs) are associated with high morbidity, costs and mortality in patients with diabetes mellitus. Their appropriate management should include several figures and a well-organized approach. This review aims to highlight the interplay between diabetes and ABSSSIs and bring out the unmet clinical needs in this area. Pathogenetic mechanisms underlying the increased risk of ABSSSIs in diabetes mellitus are multifactorial: high glucose levels play a crucial pathogenetic role in the tissue damage and delayed clinical cure. Moreover, the presence of diabetes complications (neuropathy, vasculopathy) further complicates the management of ABSSSIs in patients with diabetes. Multidrug resistance organisms should be considered in this population based on patient risk factors and local epidemiology and etiological diagnosis should be obtained whenever possible. Moreover, drug-drug interactions and drug-related adverse events (such as nephrotoxicity) should be considered in the choice of antibiotic therapy. Reducing unnecessary hospitalizations and prolonged length of hospital stay is of primary importance now, more than ever. To achieve these objectives, a better knowledge of the interplay between acute and chronic hyperglycemia, multidrug resistant etiology, and short and long-term outcome is needed. Of importance, a multidisciplinary approach is crucial to achieve full recovery of these patients.

Original languageEnglish
Article number108732
JournalDiabetes Research and Clinical Practice
Volume174
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Acute bacterial skin and skin structure infections
  • Diabetes mellitus
  • Multidrug-resistance
  • Neuropathy
  • Soft tissue infections
  • Vasculopathy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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