Diabetic foot infections (DFIs) are a major cause of morbidity and lower-limb amputations among individuals with diabetes mellitus. Inappropriate empirical antibiotic use contributes to treatment failure and elevated amputation risk. This observational study, conducted across six hospitals in Khyber Pakhtunkhwa (KP), Pakistan, involved 341 patients with clinically diagnosed DFIs. The objectives were to evaluate antibiotic efficacy, treatment outcomes, and risk factors for amputation, and to develop a visual risk stratification model correlating antibiotic response with amputation risk. The cohort exhibited a significant male predominance (64.5%, p = 0.003), with the highest prevalence among patients aged 41–50 years (36.7%). Most participants were insulin-independent (92.7%, p < 0.0001). Infection severity was mild in 28.7%, moderate in 47.8%, and severe in 23.5% of cases. Clinical outcomes included complete recovery (39.3%), improvement (31.7%), progression (19.9%), and amputation (9.1%). High-efficacy antibiotics included Levofloxacin (Levaquin, 100%), Colistin (100%), and Linezolid (Zyvox, 86.6%), whereas Ceftriaxone (Cefzone, 33.3%), Ampicillin/Sulbactam (Penro, 38.3%), and Clindamycin (Cleocin HCl, 26.6%) demonstrated limited therapeutic benefit. The visual stratification model showed that exposure to low-efficacy antibiotics significantly increased amputation risk. Logistic regression identified severe baseline infection (odds ratio (OR) ≈3.2), poor glycemic control (OR ≈ 1.9), and treatment with low-efficacy antibiotics (OR ≈ 2.8) as independent predictors of unfavorable outcomes. This study highlights the need for region-specific antibiotic stewardship, continuous resistance surveillance, and evidence-based treatment protocols. The proposed visual model offers a practical framework for guiding empirical therapy and reducing amputation rates in DFI management.