Antibiotic treatment and conservative surgery plus short-course antibiotics were similar for diabetic foot osteomyelitis.

Abstract

Lazaro-Martinez JL, Aragon-Sanchez J, Garcia-Morales E. Antibiotics Versus Conservative Surgery for Treating Diabetic Foot Osteomyelitis: A Randomized Comparative Trial. Diabetes Care. 2014 Mar;37(3):789-95. ### Question: In patients with diabetic foot osteomyelitis (DFO), how does antibiotic treatment alone compare with conservative surgery and short-course antibiotic therapy? ### Design: Randomized (allocation concealed), unblinded, controlled trial with 12 weeks of follow-up. ### Setting: The diabetic foot unit of a university hospital in Madrid, Spain. ### Patients: 52 patients >18 years of age with DFO confirmed by the probing-to-bone test and by radiography. Exclusion criteria included severe infections, presence of necrotizing soft-tissue infections, peripheral arterial disease, Charcot foot, glycated hemoglobin >10%, exposed bone in the ulcer, pregnancy, antibiotic allergies, creatinine values >98 μmol/L in women or >106 μmol/L in men, and hepatic insufficiency. 46 patients (88.5%; mean age, 69 years; 71% men) were included in the analysis. ### Intervention: Patients were allocated to antibiotic treatment (n = 25) or surgery (n = 27). The antibiotic regimen lasted up to 90 days or until healing and consisted of ciprofloxacin (500 mg) twice per day; …