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Guidelines
Diabetic Foot Infections (DFIs)

Diabetic Foot Infections (DFIs)

Clinical Considerations

Diagnostic Criteria

Diagnose infection based on:

  • Presence of purulent secretions, OR
  • Presence of ≥2 classic symptoms/signs of inflammation:
    • Erythema
    • Warmth
    • Tenderness
    • Pain
    • Induration

Etiology

Typically polymicrobial with aerobic gram-positive cocci, aerobic gram-negative rods, and anaerobes

If no break in skin

No concern for anaerobes; anaerobic coverage is not necessary

If patient is hemodynamically stable

Hold antibiotics prior to cultures

Obtain post-debridement cultures and de-escalate based upon susceptibilities

Inpatient Empiric Treatment

Mild Infection Severity (PEDIS Grade 2)

Moderate Infection Severity (PEDIS Grade 3)

Severe Infection Severity (PEDIS Grade 4)

More Information

Reference

Lipsky BA, Berendt AR, Cornia PB et al. 2012 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Treatment of Diabetic Foot Infections. Clin Infect Dis 2012;54(12):132-173.