Lipsky BA, Senneville É, Abbas ZG, Aragón-Sánchez J, Diggle M, Embil JM, Kono S, Lavery LA, Malone M, van Asten SA, Urbančič-Rovan V, Peters EJG, International Working Group on the Diabetic Foot (IWGDF)., et al.
Diabetes/metabolism research and reviews. Date of publication 2020 Mar 1;volume 36 Suppl 1():e3280.
1. Diabetes Metab Res Rev. 2020 Mar;36 Suppl 1:e3280. doi: 10.1002/dmrr.3280.
Guidelines on the diagnosis and treatment of foot infection in persons with
diabetes (IWGDF 2019 update).
Lipsky BA(1)(2), Senneville É(3), Abbas ZG(4), Aragón-Sánchez J(5), Diggle M(6),
Embil JM(7), Kono S(8), Lavery LA(9), Malone M(10), van Asten SA(11),
Urbančič-Rovan V(12), Peters EJG(13); International Working Group on the Diabetic
Foot (IWGDF).
Author information:
(1)Department of Medicine, University of Washington, Seattle, Washington.
(2)Green Templeton College, University of Oxford, Oxford, UK.
(3)Gustave Dron Hospital, Tourcoing, France.
(4)Abbas Medical Centre, Muhimbili University of Health and Allied Sciences, Dar
es Salaam, Tanzania.
(5)La Paloma Hospital, Las Palmas de Gran Canaria, Spain.
(6)Alberta Public Laboratories, University of Alberta Hospital, Edmonton,
Alberta, Canada.
(7)University of Manitoba, Winnipeg, Manitoba, Canada.
(8)WHO-collaborating Centre for Diabetes, National Hospital Organization Kyoto
Medical Center, Kyoto, Japan.
(9)Department of Plastic Surgery, University of Texas Southwestern Medical
Center, Dallas, Texas.
(10)South West Sydney Local Health District, School of Medicine, Infectious
Diseases and Microbiology, Western Sydney University, Sydney, New South Wales,
Australia.
(11)Leiden University Medical Centre, Leiden, The Netherlands.
(12)Faculty of Medicine, University Medical Centre, University of Ljubljana,
Ljubljana, Slovenia.
(13)Department of Internal Medicine, Infection and Immunity Institute, Amsterdam
UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
The International Working Group on the Diabetic Foot (IWGDF) has published
evidence-based guidelines on the prevention and management of diabetic foot
disease since 1999. This guideline is on the diagnosis and treatment of foot
infection in persons with diabetes and updates the 2015 IWGDF infection
guideline. On the basis of patient, intervention, comparison, outcomes (PICOs)
developed by the infection committee, in conjunction with internal and external
reviewers and consultants, and on systematic reviews the committee conducted on
the diagnosis of infection (new) and treatment of infection (updated from 2015),
we offer 27 recommendations. These cover various aspects of diagnosing soft
tissue and bone infection, including the classification scheme for diagnosing
infection and its severity. Of note, we have updated this scheme for the first
time since we developed it 15 years ago. We also review the microbiology of
diabetic foot infections, including how to collect samples and to process them to
identify causative pathogens. Finally, we discuss the approach to treating
diabetic foot infections, including selecting appropriate empiric and definitive
antimicrobial therapy for soft tissue and for bone infections, when and how to
approach surgical treatment, and which adjunctive treatments we think are or are
not useful for the infectious aspects of diabetic foot problems. For this version
of the guideline, we also updated four tables and one figure from the 2016
guideline. We think that following the principles of diagnosing and treating
diabetic foot infections outlined in this guideline can help clinicians to
provide better care for these patients.
© 2020 John Wiley & Sons Ltd.
DOI: 10.1002/dmrr.3280
PMID: 32176444 [Indexed for MEDLINE]
