The review considers the problem of choosing an effective antibiotic for starting and purposeful antimicrobial therapy of purulent-necrotic complications of diabetic foot syndrome. It is shown that empirical antibacterial therapy should be carried out taking into account the previous treatment, clinical data, existing clinical, national and international recommendations, as well as based on the data of local bacteriological monitoring, and taking into account the possibility of the influence of antibiotics (stimulation/inhibition) on the ability of microorganisms to form biofilms and persist in the body. It is proposed to determine the sensitivity to antibiotics of 10 isolated pure cultures of microorganisms of the same species, and to give preference to the antibiotic, to which all isolated clones of this type of bacteria are susceptible. The use of an antibiotic selected according to the proposed technique allows sanitizing the focus of purulent inflammation in a short time and reducing the number of high amputations by 2 times.