IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023).

Autor: Senneville É; Gustave Dron Hospital, Tourcoing, France.; Univ-Lille France, Lille, France., Albalawi Z; Department of Medicine, Division of Endocrinology, Memorial University, St. John's, Newfoundland and Labrador, Canada., van Asten SA; Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands., Abbas ZG; Abbas Medical Centre, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Allison G; Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA., Aragón-Sánchez J; La Paloma Hospital, Las Palmas de Gran Canaria, Spain., Embil JM; Department of Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada., Lavery LA; Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA., Alhasan M; Department of Medicine, Prisma Health-Midlands, Columbia, South Carolina, USA., Oz O; UT Southwestern Medical Center, Dallas, Texas, USA., Uçkay I; Balgrist University Hospital, Zurich, Switzerland., Urbančič-Rovan V; Faculty of Medicine, University Medical Centre, University of Ljubljana, Ljubljana, Slovenia., Xu ZR; Diabetes Centre, Beijing, China., Peters EJG; Department of Internal Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Section of Infectious Diseases, Amsterdam, the Netherlands.; Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, the Netherlands.; Amsterdam Infection & Immunity, Infectious Diseases, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Diabetes/metabolism research and reviews [Diabetes Metab Res Rev] 2024 Mar; Vol. 40 (3), pp. e3687. Date of Electronic Publication: 2023 Oct 01.
DOI: 10.1002/dmrr.3687
Abstrakt: The International Working Group on the Diabetic Foot (IWGDF) has published evidence-based guidelines on the management and prevention of diabetes-related foot diseases since 1999. The present guideline is an update of the 2019 IWGDF guideline on the diagnosis and management of foot infections in persons with diabetes mellitus. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used for the development of this guideline. This was structured around identifying clinically relevant questions in the P(A)ICO format, determining patient-important outcomes, systematically reviewing the evidence, assessing the certainty of the evidence, and finally moving from evidence to the recommendation. This guideline was developed for healthcare professionals involved in diabetes-related foot care to inform clinical care around patient-important outcomes. Two systematic reviews from 2019 were updated to inform this guideline, and a total of 149 studies (62 new) meeting inclusion criteria were identified from the updated search and incorporated in this guideline. Updated recommendations are derived from these systematic reviews, and best practice statements made where evidence was not available. Evidence was weighed in light of benefits and harms to arrive at a recommendation. The certainty of the evidence for some recommendations was modified in this update with a more refined application of the GRADE framework centred around patient important outcomes. This is highlighted in the rationale section of this update. A note is also made where the newly identified evidence did not alter the strength or certainty of evidence for previous recommendations. The recommendations presented here continue to cover various aspects of diagnosing soft tissue and bone infections, including the classification scheme for diagnosing infection and its severity. Guidance on how to collect microbiological samples, and how to process them to identify causative pathogens, is also outlined. Finally, we present the approach to treating foot infections in persons with diabetes, including selecting appropriate empiric and definitive antimicrobial therapy for soft tissue and bone infections; when and how to approach surgical treatment; and which adjunctive treatments may or may not affect the infectious outcomes of diabetes-related foot problems. We believe that following these recommendations will help healthcare professionals provide better care for persons with diabetes and foot infections, prevent the number of foot and limb amputations, and reduce the patient and healthcare burden of diabetes-related foot disease.
(© 2023 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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