Guidelines
Diabetic Foot Infection (DFI)

Diabetic Foot Infection (DFI)

Definitions

  • Erythema ≥ 0.5 cm but ≤ 2 cm
  • No deep tissue involvement
  • No systemic toxicity
  • Erythema > 2 cm

OR

  • Deep tissue involvement: abscess, osteomyelitis, septic arthritis, fasciitis, gangrene
  • No systemic toxicity
  • Same as moderate DFI

PLUS

  • Systemic toxicity or metabolic instability

Microbiology

Beta-hemolytic Streptococcus (Groups A & B)

Gram negatives more likely if recent antibiotic use or chronic ulcer

Polymicrobial PLUS Anaerobes more likely if necrosis or gangrene

Additional Information

Guideline originally sourced from Saskatchewan Health Authority - Saskatoon Area and adapted by Joseph Brant Hospital

  • Lipsky BA, Berendt AR, Cornia PB et al . Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis, 2012; 54: e132– e173.

  • Lipsky BA, Aragón-Sánchez J, Diggle M, et al. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev. 2016;32 Suppl 1:45-74.

  • The Johns Hopkins University (2020) John Hopkins ABX Guide (1.27) [Mobile App] Retrieved from: www.hopkinsguides.com

  • Antimicrobial Therapy Inc (2020) The Sanford Guide (4.2) [Mobile App] Retrieved from: www.sanfordguide.com/

Approved June 2020