Purpose: Diabetic foot infections (DFIs) are associated with significant morbidity. Systemic antimicrobials are often required and can have adverse effects. Moreover, delivery of antimicrobials can be limited if the circulation is compromised. The use of topical antibiotic beads, Stimulan, has been described in bone infections. However, the benefits of its use in DFIs, particularly in severe infections, is unclear. The aim of this study was to evaluate the outcomes of Stimulan in patients with DFIs. Methodology: This was a prospective single-centre study of patients with DFIs who received Stimulan for severe DFIs between Aug 2023–Jul 2024. Baseline demographics, limb characteristics, and outcomes were collected. Primary outcomes were time to healing, limb loss, and death. A control group from the period immediately prior to the introduction of Stimulan was used for comparison. Data was analysed using t-tests, χ2 tests, and regression analysis, and is expressed as mean±SD or %. Results: Overall 159 patients were included, of which 43 (64±13y, 63% male) received Stimulan, and 116 were controls (67±14y, 68% male). Baseline characteristics were not significantly different between groups except for a higher rate of peripheral arterial disease in the control group (67% vs 44%; p=0.008), and a higher WIfI stage in the Stimulan group (91% stage 3 or 4; p<0.0001). Time to healing (123±60d vs 159±125d), limb loss (15% vs 17%), and 30-day death did not differ between groups on univariate analysis. When WIfI stage was adjusted for in multivariate analysis, patients that did not receive Stimulan had a statistically significant risk for limb loss (OR 2.81, p=0.05) and death (OR 6.71, p=0.002), but not for wound healing. Conclusion: This study suggests that the use of Stimulan in patients with severe DFIs is associated with a lower rate of limb loss and death. Further validation and follow-up is required to determine the benefits of topical antibiotic therapy.