A prospective study on the effectiveness of antibiotic impregnated beads in treating osteomyelitis in diabetic foot patients

Abstract

Background: Diabetic foot infections are the most common skeletal and soft tissue infections in diabetic patients. Oral antibiotics with good oral bioavailability and local delivery of antibiotics in the form of beads are being used. In this study, we analysed the effectiveness of antibiotic-impregnated beads in treating osteomyelitis in diabetic foot patients. We also analysed the microbiological profile among the study groups.Methods: This was a prospective comparative study where 60 patients were selected from the general surgery and podiatry departments at Amrita Institute of Medical Sciences, Cochin, between August 2017 till August 2019. Antibiotic beads were used in the ‘bead’ group and oral antibiotics in the ‘no bead’ group, with empirical i.v. antibiotics in both groups. All patients were reviewed for six months, and ulcers not healing within six months were taken as failed therapy.Results: Among the 60 patients in the study population, 51 showed healing, and 9 did not heal. Out of the nine which did not heal, 7 (23.2%) belonged to the no bead group and 2 (6.7%) to the bead group. The mean healing duration in the no bead group was 74.70±30.25 days, while that in the bead group was 81.18±30.80 days. The most typical isolated organism was Staphylococcus aureus, which was found in 38.3%.Conclusions: We have found that using antibiotic beads improves patient convenience by reducing hospital visits and the need for daily dressing without compromising the healing rate.