Bonnet E, Maulin L, Senneville E, Castan B, Fourcade C, Loubet P, Poitrenaud D, Schuldiner S, Sotto A, Lavigne JP, Lesprit P, individual members of the “Review group”, et al.
Infectious diseases now. Date of publication 2024 Feb 1;volume 54(1):104832.
1. Infect Dis Now. 2024 Feb;54(1):104832. doi: 10.1016/j.idnow.2023.104832. Epub
2023 Nov 10.
Clinical practice recommendations for infectious disease management of diabetic
foot infection (DFI) - 2023 SPILF.
Bonnet E(1), Maulin L(2), Senneville E(3), Castan B(4), Fourcade C(5), Loubet
P(6), Poitrenaud D(7), Schuldiner S(8), Sotto A(6), Lavigne JP(9), Lesprit
P(10); individual members of the “Review group”.
Author information:
(1)Service des Maladies Infectieuses et Tropicales, CHU Toulouse-Purpan, 31059
Toulouse, France. Electronic address: bonnet.e@chu-toulouse.fr.
(2)Maladies Infectieuses, CH du Pays d'Aix, 13100 Aix en Provence, France.
(3)Service Universitaire des Maladies Infectieuses, CH Dron, 59200 Tourcoing,
France.
(4)Service de Médecine Interne et Maladies Infectieuses, CH Périgueux, 24019
Périgueux, France.
(5)Equipe Mobile d'Infectiologie, Clinique Pasteur, Clinavenir, 31300 Toulouse,
France.
(6)Service des Maladies Infectieuses et Tropicales, CHU Caremeau, 30029 Nîmes,
France.
(7)Unité Fonctionnelle d'Infectiologie, CH Notre Dame de la Miséricorde, 20000
Ajaccio, France.
(8)Service des Maladies Métaboliques et Endocriniennes, CHU Caremeau, 30029
Nîmes, France.
(9)Service de Microbiologie et Hygiène Hospitalière, CHU Caremeau, 30029 Nîmes,
France.
(10)Maladies Infectieuses, CHU Grenoble Alpes, 38043, Grenoble, France.
In march 2020, the International Working Group on the Diabetic Foot (IWGDF)
published an update of the 2015 guidelines on the diagnosis and management of
diabetic foot infection (DFI). While we (the French ID society, SPILF) endorsed
some of these recommendations, we wanted to update our own 2006 guidelines and
specifically provide informative elements on modalities of microbiological
diagnosis and antibiotic treatment (especially first- and second-line regiments,
oral switch and duration). The recommendations put forward in the present
guidelines are addressed to healthcare professionals managing patients with DFI
and more specifically focused on infectious disease management of this type of
infection, which clearly needs a multidisciplinary approach. Staging of the
severity of the infection is mandatory using the classification drawn up by the
IWGDF. Microbiological samples should be taken only in the event of clinical
signs suggesting infection in accordance with a strict preliminarily established
protocol. Empirical antibiotic therapy should be chosen according to the IWGDF
grade of infection and duration of the wound, but must always cover
methicillin-sensitive Staphylococcus aureus. Early reevaluation of the patient
is a fundamental step, and duration of antibiotic therapy can be shortened in
many situations. When osteomyelitis is suspected, standard foot radiograph is
the first-line imagery examination and a bone biopsy should be performed for
microbiological documentation. Histological analysis of the bone sample is no
longer recommended. High dosages of antibiotics are recommended in cases of
confirmed osteomyelitis.
Copyright © 2023 Elsevier Masson SAS. All rights reserved.
DOI: 10.1016/j.idnow.2023.104832
PMID: 37952582 [Indexed for MEDLINE]
Conflict of interest statement: Declaration of competing interest The authors
declare that they have no known competing financial interests or personal
relationships that could have appeared to influence the work reported in this
paper.
