Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)
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DOI：
10.1002/dmrr.3280
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发表时间：
2020-03-01
影响因子：
8
通讯作者：
Peters, Edgar J. G.
中科院分区：
文献类型：
--
作者：
Lipsky, Benjamin A.;Senneville, Eric;Peters, Edgar J. G.
国际糖尿病足工作组（IWGDF）自1999年以来发布了关于糖尿病足疾病预防和管理的循证指南。本指南是关于糖尿病患者足部感染的诊断和治疗，并更新了2015年IWGDF感染指南。根据感染委员会与内部和外部评审员和顾问共同制定的患者、干预、比较、结局（PICO），以及委员会对感染诊断（新）和感染治疗（自2015年以来更新）进行的系统性审查，我们提供了27项建议。这些涵盖了诊断软组织和骨感染的各个方面，包括诊断感染及其严重程度的分类方案。值得注意的是，我们自15年前开发以来首次更新了该计划。我们还回顾了糖尿病足感染的微生物学，包括如何收集样本和处理它们以识别致病病原体。最后，我们讨论了治疗糖尿病足感染的方法，包括选择适当的经验性和明确的抗菌治疗软组织和骨感染，何时以及如何接近手术治疗，以及哪些预防性治疗，我们认为是或不是有用的糖尿病足问题的感染方面。对于此版本的指南，我们还更新了2016年指南中的四个表格和一个图。我们认为，遵循本指南中概述的诊断和治疗糖尿病足感染的原则可以帮助临床医生为这些患者提供更好的护理。
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 15years 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.