What Researchers Did
A panel of experts reviewed the evidence on diagnosing and treating bone infection in diabetic foot ulcers, known as diabetic foot osteomyelitis.
What They Found
This systematic review of 19 studies (selected from 1168 identified papers) found no significant differences in outcome associated with any particular treatment strategy for diabetic foot osteomyelitis. The panel found no evidence that surgical removal of infected bone is routinely necessary. Bone biopsy culture results may help select targeted antibiotics, but there was no data showing any particular route or duration of antibiotic therapy works better than another. The review found no available evidence supporting adjunctive therapies such as hyperbaric oxygen, growth factor injections, or larvae therapy for this condition.
What This Means for Canadian Patients
For Canadian patients with diabetic foot osteomyelitis, this review indicates that treatment choices among antibiotic routes, durations, and surgical approaches have not been shown to differ in outcome based on available evidence. It specifically found no evidence to support hyperbaric oxygen as an add-on treatment for this condition. The authors describe the evidence base as limited, so treatment decisions should be individualized with a care team.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
Only 19 of 1168 identified papers met the panel's criteria for detailed data extraction, and the authors describe the overall data on treatment choices for diabetic foot osteomyelitis as limited.