• 1

    Lipsky BA: A report from the international consensus on diagnosing and treating the infected diabetic foot. .Diabetes Metab Res Rev 20: (suppl 1):S68. ,2004. .

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  • 2

    Lipsky BA, Berendt AR, Deery HG, et al: Infectious Disease Society of America. Diagnosis and treatment of diabetic foot infections. .Clin Infect Dis 39::885. ,2004. .

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  • 3

    Lavery LA, Armstrong DG, Murdoch DP, et al: Validation of the Infectious Diseases Society of America’s diabetic foot infection classification system. .Clin Infect Dis 44::562. ,2007. .

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  • 4

    Rao N, Lipsky BA: Optimising antimicrobial therapy in diabetic foot infections. .Drugs 67::195. ,2007. .

  • 5

    Van Acker K, De Block C, Abrams P, et al: The choice of diabetic foot ulcer classification in relation to the final outcome. .Wounds 14::16. ,2002. .

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  • 6

    Armstrong DG, Lavery LA, Harkless LB: Validation of a diabetic wound classification system: the contribution of depth, infection, and ischemia to risk of amputation. .Diabetes Care 21::855. ,1998. .

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  • 7

    Lipsky BA, Itani K, Norden C; Linezolid Diabetic Foot Infections Study Group: Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. .Clin Infect Dis 38::17. ,2004. .

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  • 8

    Berendt AR, Peters EJ, Bakker K, et al: Diabetic foot osteomyelitis: a progress report on diagnosis and a systematic review of treatment. .Diabetes Metab Res Rev 24: (suppl 1):S145. ,2008. .

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  • 9

    Teh J, Berendt T, Lipsky BA: Rational imaging: investigating suspected bone infection in the diabetic foot. .BMJ 339::b4690. ,2009. .

  • 10

    Nawaz A, Torigian DA, Siegelman ES, et al: Diagnostic performance of FDG-PET, MRI, and plain film radiography (PFR) for the diagnosis of osteomyelitis in the diabetic foot. .Mol Imaging Biol 12::335. ,2010. .

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  • 11

    Bowling FL, Jude EB, Boulton AJ: MRSA and diabetic foot wounds: contaminating or infecting organisms?. Curr Diab Rep 9::440. ,2009. .

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  • 13

    Gould IM: Clinical relevance of increasing glycopeptide MICs against Staphylococcus aureus. .Int J Antimicrob Agents 31: (suppl 2):1. ,2008. .

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  • 16

    Lipsky BA, Tabak YP, Johannes RS, et al: Skin and soft tissue infections in hospitalised patients with diabetes: culture isolates and risk factors associated with mortality, length of stay and cost. .Diabetologia 53::914. ,2010. .

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  • 17

    Nicolau DP, Stein GE: Therapeutic options for diabetic foot infections: a review with an emphasis on tissue penetration characteristics. .JAPMA 100::52. ,2010. .

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Medical Therapy of Diabetic Foot Infections

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  • 1 Journal of the American Podiatric Medical Association, Bethesda, MD; Roxborough Memorial Hospital, Philadelphia, PA.
  • | 2 University of Washington and Primary Care Clinic, Antibiotic Research, VA Puget Sound HCS, Seattle, WA.
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Diabetic foot infections are a common and often serious problem, accounting for more hospital bed days than any other complication of diabetes. Despite advances in antibiotic drug therapy and surgical management, these infections continue to be a major risk factor for amputations of the lower extremity. Although a variety of wound size and depth classification systems have been adapted for use in codifying diabetic foot ulcerations, none are specific to infection. In 2003, the International Working Group on the Diabetic Foot developed guidelines for managing diabetic foot infections, including the first severity scale specific to these infections. The following year, the Infectious Diseases Society of America published their diabetic foot infection guidelines. Herein, we review some of the critical points from the Executive Summary of the Infectious Diseases Society of America document and provide a commentary following each issue to update the reader on any pertinent changes that have occurred since publication of the original document in 2004.

The importance of a multidisciplinary limb salvage team, apropos of this special issue jointly published by the American Podiatric Medical Association and the Society for Vascular Surgery, cannot be overstated. (J Am Podiatr Med Assoc 100(5): 395–400, 2010)

Corresponding author: Warren S. Joseph, DPM, Journal of the American Podiatric Medical Association, 1109 Old Ford Rd, Huntingdon Valley, PA 19006. (E-mail: wsjoseph@comcast.net)