Foot ulceration in people with diabetes continues to be challenging for both those affected and the healthcare professionals who look after them. Identification and treatment of infection is an important step in management although despite useful progress in both imaging of deep tissues and detection of pathogens, clinical assessment using parameters such as “sausage” digits, probe-to-bone testing and IDSA infection grading criteria (Table 1) remain the most useful and appropriate guidelines. Key points with respect to treating DFI are summarised in Figure 2. Whilst narrow spectrum, tailored antibiotic therapy is recommended, it is accepted that empirical treatment is often required, ideally after appropriate tissue sampling (Figure 3). In the absence of novel antibiotics, the attached guideline should prove to be a useful tool in supporting clinical decision-making with respect to antimicrobial therapy (Table 2). Antibiotic choice should then be reviewed once culture results become available.