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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]
Appears in following Topics:
Antimicrobial Stewardship In Wound Care
Wound Infection - Overview