IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF/IDSA 2023).
Senneville É, Albalawi Z, van Asten SA, et al. Diabetes/metabolism research and reviews 2024 · PMID 37779323 · doi:10.1002/dmrr.3687
- Question
- How should diabetes-related foot infections, including osteomyelitis, be diagnosed, classified and treated?
- Design
- International evidence-based guideline from the International Working Group on the Diabetic Foot and the Infectious Diseases Society of America, using GRADE.
- Patients
- People with diabetes and suspected or confirmed foot infection or osteomyelitis.
- Intervention
- Clinical diagnosis and IWGDF/IDSA severity classification, probe-to-bone and imaging, bone sampling, antibiotic and surgical management
- Comparison
- Not applicable
- Primary outcome
- Guideline recommendations
- Key result
- Recommends diagnosing soft-tissue infection clinically and grading its severity with the IWGDF/IDSA classification, a structured work-up for suspected osteomyelitis (probe-to-bone, plain radiographs, inflammatory markers and MRI where uncertain), deep tissue or bone sampling for culture rather than superficial swabs, and shorter, targeted antibiotic courses.
- Limitations
- Many recommendations rest on low-certainty evidence; resource assumptions (MRI, bone biopsy) may not match all settings.
- Impact on practice
- The international reference for diabetic foot infection, complementing NICE NG19 and supporting shorter, targeted antibiotic courses in UK practice.