The Infectious Diseases Society of America (IDSA) released new guidelines suggesting how to improve proper care of diabetic foot infections and reduce amputations.
Diabetic complications are a leading cause of lower extremity amputations, and about 50% of people who have had a diabetes-related amputation die within 5 years of the amputation, according to a press release. Since the previously published IDSA guidelines in 2004, new research has shown that physicians may treat foot infections improperly, including prescribing the wrong antibiotic, neglecting proper wound care and surgical intervention and not addressing underlying conditions such as peripheral artery disease.
“There is quite a bit of over-prescribing or inappropriate prescribing of antibiotics for diabetic foot wounds, which doesn’t help the patient and can lead to antibiotic resistance,” Warren S. Joseph, DPM, co-author of the guidelines and consultant for lower extremity infectious diseases at Roxborough Memorial Hospital in Philadelphia, stated in the release. “The guidelines note that when antibiotics are necessary they should be discontinued when the infection is gone, even if the wound hasn’t completely healed.”
The new guidelines suggest that most diabetes-related amputations can be prevented and emphasize the importance of rapid and appropriate therapy for treating infected wounds through a multidisciplinary team, including infectious diseases specialists, podiatrists, surgeons and orthopedists.
Typical treatment should include surgical debridement of the dead tissue, appropriate antibiotic therapy after an infection has been confirmed and the type of bacteria causing the infection has been identified and, if necessary, removal of pressure from the wound and improving blood flood to the affected area. The guidelines also emphasize the importance of determining whether the bone has been affected by the infection.
The complete list of guidelines is published in Critical Infections Diseases.