Diagnosis and Treatment of Diabetic Foot Infections
Benjamin A. Lipsky,1,a Anthony R. Berendt,2,a H. Gunner Deery,3 John M. Embil,4 Warren S. Joseph,5 Adolf W. Karchmer,6 Jack L.LeFrock,7 Daniel P. Lew,8 Jon T. Mader,9,b Carl Norden,10 and James S. Tan11
Medical Service, Veterans Affairs Puget Sound Health Care System, and Division of General Internal Medicine, Department ofMedicine, University of Washington School of Medicine, Seattle, Washington; 2Bone Infection Unit, Nufﬁeld Orthopaedic Centre, Oxford, United Kingdom; 3 Northern Michigan Infectious Diseases,Petoskey, Michigan; 4Section of Infectious Diseases, Department of Medicine, University of Manitoba, Winnipeg, Manitoba; 5Section of Podiatry, Department of Primary Care, Veterans Affairs Medical Center,Coatesville, Pennsylvania; 6Division of Infectious Diseases, Department of Medicine, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts; 7 Dimensional Dosing Systems,Sarasota, Florida; 8Department of Medicine, Service of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland; 9Department of Internal Medicine, The Marine Biomedical Institute, andDepartment of Orthopaedics and Rehabilitation, University of Texas Medical Branch, Galveston, Texas; 10Department of Medicine, New Jersey School of Medicine and Dentistry, and Cooper Hospital, Camden,New Jersey; and 11Department of Internal Medicine, Summa Health System, and Northeastern Ohio Universities College of Medicine, Akron, Ohio
EXECUTIVE SUMMARY 1. Foot infections in patients withdiabetes cause substantial morbidity and frequent visits to health care professionals and may lead to amputation of a lower extremity. 2. Diabetic foot infections require attention to local (foot)and systemic (metabolic) issues and coordinated management, preferably by a multidisciplinary footcare team (A-II) (table 1). The team managing these infections should include, or have ready access...