title: Diabetic foot infections: what have we learned in the last 30 years?
abstract: BACKGROUND
  Infection is a common epiphenomenon of advanced diabetic foot disease and the most common reason for diabetes-related hospitalizations and lower extremity amputations. Major advances have been made in the past three decades in our understanding and management of diabetic foot infections (DFIs). The optimal treatment of DFIs clearly involves multidisciplinary input.
  
  
  METHODS
  A comprehensive search of the literature on DFIs from January 1960 through June 2015 was performed, with an emphasis on information published in the past 30 years.
  
  
  RESULTS
  There have been many new insights into the microbiology, diagnosis, and treatment of DFIs, although the implementation of this knowledge in clinical practice has been suboptimal. Today, the use of evidence-based guidelines, multidisciplinary teams, and institution-specific clinical pathways helps guide optimal care of this multifaceted problem. Patients are more often treated in the ambulatory setting, with antibiotic regimens that are more targeted, oral and shorter course, and with more conservative (but earlier) surgical interventions. New diagnostic and therapeutic methods are being developed at an accelerating pace.
  
  
  CONCLUSIONS
  The worldwide increase in the incidence of diabetes and longer lifespan of diabetic patients will undoubtedly increase the incidence of DFIs. Clinicians caring for diabetic patients should have an understanding of current methods for preventing, diagnosing, and treating DFIs.
authors.affiliation: Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Orthopaedic Surgery Service, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4, rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland. Electronic address: ilker.uckay@hcuge.ch.
authors.forename: Ilker
authors.initials: I
authors.lastname: Uçkay
authors.affiliation: Diabetic Foot Unit, Service of Surgery, La Paloma Hospital, Las Palmas de Gran Canaria, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Aragón-Sánchez
authors.affiliation: Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lew
authors.affiliation: Service of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Medical Sciences, University of Oxford, Oxford, UK.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lipsky
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology*; D017719:Diabetic Foot / Q000382:microbiology*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic; Diabetic foot infection; Pathogens; Surgery; Treatment