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Updated NICE diabetic footcare guideline published

By Editor
19th October 2019
Clinical guidance, Footcare Guidelines

The NICE guideline for the prevention and management of diabetic foot problems has been updated.

The evidence for antimicrobial prescribing for diabetic foot infections in NICE guideline [NG19], Diabetic foot problems: prevention and management has been reviewed, with the recommendations updated.

The updated version now also includes a three-page visual summary of the antimicrobial prescribing recommendations, including tables to support prescribing decisions.

The guideline, which was originally published in August 2015, covers preventing and managing foot problems in children, young people and adults with diabetes. It aims to reduce variation in practice, including antibiotic prescribing for diabetic foot infections.

Explaining the committee made the 2019 recommendations on antibiotic treatment for people with diabetic foot infection and how they might affect practice, the guideline states: “The committee agreed that in people with diabetes, all foot wounds are likely to be colonised with bacteria. However, for people with a diabetic foot infection, prompt treatment of the infection is important to prevent complications, including limb-threatening infections.

“The committee agreed to retain the recommendation from the 2015 guideline that antibiotics should be started as soon as possible if a diabetic foot infection is suspected. The choice of antibiotic would depend on the severity of infection, although the committee acknowledged that the studies they looked at did not always differentiate between severities. The committee accepted the Infectious Diseases Society of America’s definitions of mild, moderate and severe infection, and recommended that this should be taken into account when choosing an antibiotic.

“The committee retained the 2015 recommendation that samples should be taken for microbiological testing before, or as close as possible to, the start of antibiotic treatment. This would allow empirical antibiotic treatment to be changed if needed when results are available.”

To access the updated guideline, click here.

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