Antibiotics Versus ConservativeSurgery for Treating Diabetic Foot

Osteomyelitis: A RandomizedComparative Trial

Featured Article:

José Luis Lázaro-Martínez, Javier Aragón- Sánchez, and Esther García-Morales

Diabetes Care Volume 37: 789-795

March, 2014

STUDY OBJECTIVE 

• To compare the treatment outcomes of diabetic foot osteomyelitis in patients treated exclusively with antibiotics versus patients who underwent conservative surgery

• Follow-up occurred for 12 weeks after healing

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

STUDY DESIGN AND METHODS

• Prospective randomized comparative trial was carried out in diabetes patients with neuropathic foot ulcers complicated by osteomyelitis

• Patients were randomized into two groups:

• Antibiotics group (AG)

• Surgical group (SG)

• Antibiotics were given for 90 days in AG

• SG received conservative surgery with postoperative antibiotic treatment for 10 days

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

RESULTS

• 18 patients (75%) achieved primary healing in AG and 19 (86.3%) in SG

• Median time to healing was 7 weeks in AG and 6 weeks in SG

• Conditions of four patients from AG worsened (16.6%), and they underwent surgery

• Three patients from SG required reoperation

• No difference was found between the two groups regarding minor amputations

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

CONCLUSIONS

• Antibiotic therapy and surgical treatment had similar outcomes in terms of healing rates, time to healing, and short-term complications

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795

Lázaro-Martínez J. L. et al. Diabetes Care 2014;37:789-795