Diabetic Foot Infections: A Toolkit for Wound Care Clinicians
Kyle Kilby1, Christopher Lata2, Lucas Castellani3
1Infectious Diseases Subspeciality Resident, University of Calgary, Calgary, Alberta, Canada.
Abstract:
Diabetic foot infections (DFIs) are a serious complication of diabetes, leading to high rates of hospital admission, amputation, and early death-particularly in persons living in resource-limited communities. Although the updated International Working Group on the Diabetic Foot guidelines in 2024 provide well-laid-out strategies for managing DFIs, these tend to be better suited for use in well-resourced centers. This case-based review discusses and applies these guidelines for an approach to DFI in real-world scenarios. It focuses on supporting health care providers working in community and resource-limited settings. The review explores how to recognize and diagnose DFI, including the use of imaging modalities, and how to distinguish soft tissue infection from bone infection or noninfectious entities. Management strategies are detailed regarding antibiotic considerations and approaches, including in resource-limited settings, and when other interventions or surgical referral may be important. Practical clinical cases are used to illustrate key points, emphasizing how care may be adapted based on the context. The authors also consider health equity aspects by identifying barriers that may be faced by patients who are from racialized backgrounds and live in resource-limited settings. The review aims to equip frontline wound clinicians with a pragmatic approach to managing DFIs that is grounded in up-to-date evidence framed in a real-world context.JOURNAL/aswca/04.03/00129334-202604000-00004/figure1/v/2026-03-10T151712Z/r/image-jpeg GENERAL PURPOSE: To provide clinicians with an evidence-based approach to the diagnosis and management of diabetic foot infections (DFIs). TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:Analyze evidence-based clinical and laboratory findings to accurately diagnose (DFIs) and diabetic foot osteomyelitis.Evaluate patient-specific clinical data to select evidence-based management strategies for patients with (DFIs) and diabetic foot osteomyelitis.
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