Header

UZH-Logo

Maintenance Infos

Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge


Maurer, Steven M; Hepp, Zehra S; McCallin, Shawna; Waibel, Felix W A; Romero, Federico C; Zorman, Yılmaz; Lipsky, Benjamin A; Uçkay, İlker (2022). Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge. Journal of bone and joint infection, 7(2):61-70.

Abstract

Diabetic foot infection is a frequent complication in long-standing diabetes mellitus. For antimicrobial therapy of this infection, both the optimal duration and the route of administration are often based more on expert opinion than on published evidence. We reviewed the scientific literature, specifically seeking prospective trials, and aimed at addressing two clinical issues: (1) shortening the currently recommended antibiotic duration and (2) using oral (rather than parenteral) therapy, especially after the patient has undergone debridement and revascularization. We also reviewed some older key articles that are critical to our understanding of the treatment of these infections, particularly with respect to diabetic foot osteomyelitis. Our conclusion is that the maximum duration of antibiotic therapy for osteomyelitis should be no more than to 4-6 weeks and might even be shorter in selected cases. In the future, in addition to conducting randomized trials and propagating national and international guidance, we should also explore innovative strategies, such as intraosseous antibiotic agents and bacteriophages.

Abstract

Diabetic foot infection is a frequent complication in long-standing diabetes mellitus. For antimicrobial therapy of this infection, both the optimal duration and the route of administration are often based more on expert opinion than on published evidence. We reviewed the scientific literature, specifically seeking prospective trials, and aimed at addressing two clinical issues: (1) shortening the currently recommended antibiotic duration and (2) using oral (rather than parenteral) therapy, especially after the patient has undergone debridement and revascularization. We also reviewed some older key articles that are critical to our understanding of the treatment of these infections, particularly with respect to diabetic foot osteomyelitis. Our conclusion is that the maximum duration of antibiotic therapy for osteomyelitis should be no more than to 4-6 weeks and might even be shorter in selected cases. In the future, in addition to conducting randomized trials and propagating national and international guidance, we should also explore innovative strategies, such as intraosseous antibiotic agents and bacteriophages.

Statistics

Citations

Dimensions.ai Metrics
7 citations in Web of Science®
7 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

10 downloads since deposited on 19 Jan 2023
4 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Orthopedics and Sports Medicine
Health Sciences > Infectious Diseases
Language:English
Date:25 March 2022
Deposited On:19 Jan 2023 11:06
Last Modified:27 Jun 2024 01:41
Publisher:Ivyspring International Publisher
ISSN:2206-3552
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.5194/jbji-7-61-2022
PubMed ID:35415069
  • Content: Published Version
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)