ANTIMICROBIAL STEWARDSHIP.  'Nuff said:
 
SOURCE:  Downloaded from -->  http://cid.oxfordjournals.org/
at IDSA on May 22, 2012
 
LINK:  http://www.idsociety.org/Antimicrobial_Agents/#Antimicrobial%20Stewardship
 
TITLE: 
"2012 Infectious Diseases Society of America
Clinical Practice Guideline for the Diagnosis
and Treatment of Diabetic Foot Infections"
 
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This paper by Lipsky, et al is mentioned alot in the PresentWOC CMEs and was cited several times at Desert Bones 2013.  By the respective speakers, we are told that it is quite lengthy, but that the first 12 pages (the executive summary) is the meat & potatoes.  It is numbered, has useful quick access headings, as well as charts and tables- making it quite user friendly.
 
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WG
  • Comments (6)
  • These guidelines were submitted to the IDSA for review at least a year before publication in 2012.  At the time of submission KPCs (now more appropriately called CREs for "carbapenem resistent enterobacteriaceae") were a relatively recent development and not reported in DFI.  We did, however, discuss ESBLs of which CRE is a subset, in both questions 5 and 6.  I agree that CRE has become a much more significant problem over the past few years. 

    As for gentian violet, these are "evidence based guidelines".  I do not believe that there is any published evidence to support the use of gentian violet for the treatment of diabetic foot infections and therefore it would not be included.

  • Wait a second what about Klebsiella pneumoniae Carbapenemase? What page of this paper addresses this? Then again what about any mention about gencian violet solution?

     

    Daniel

  • Thanks for your complement, as sarcastic as it may have been.  Just FYI, I DO approve of the IDSA DFI Guidelines, I am one of the authors!

  • Suhad, I understand it's validity - I was just poking fun at the Warren Joseph "groupies".

    :-)

  • The IDSA guidelines are sited quite a bit and for good reason. They help to guide therapy and give appropriate recommendations to treatment by:

    1. Enabling one to stratify the Infection risk into a risk category (Grade 1 to Grade 4) depending on infection severity

    2. It is in a question - answer format providing guidelines to therapy; answering 10 key questions surrounding diabetic foot infections

    3. Each recommendation is accompanied by a "summary of the evidence" therefore paring the strength of the  recommendation with a quality of evidence

    4. Its benefits have been validated in the works of Lavery L. et al. Clinical Infectious Diseases. 2007

     

     

     

     

     

     

  • Does Warren Joseph approve? I'm not touching it unless Warren Joseph approves!

    Sorry, I couldn't resist, my generation was taught that Warren Joseph WAS the authority on diabetic infections and the antibiotic management of the such.

    :-)