Local antibiotic delivery systems increase healing rates in diabetic foot osteomyelitis compared with control groups in this meta-analysis
Photo by Myriam Zilles / Unsplash
Key Takeaway
Consider local antibiotic delivery systems for diabetic foot osteomyelitis to potentially improve healing rates.
This systematic review and meta-analysis examined the use of local antibiotic delivery systems for patients with diabetic foot osteomyelitis. The analysis pooled data from studies involving 491 patients to compare outcomes against a control group. The primary outcome assessed was the healing rate. Results indicated a significantly higher healing rate in the antibiotic group with a relative risk of 1.18 and a 95% CI of 1.01 to 1.38. Secondary outcomes included recurrence rates, amputation rates, healing time, and hospital stays. No significant differences were found for these secondary outcomes, with relative risks or mean differences showing wide confidence intervals that crossed the null value. For example, recurrence rates showed a relative risk of 0.30 with a 95% CI of 0.04 to 2.12. Amputation rates had a relative risk of 0.22 with a 95% CI of 0.03 to 1.91. Healing time and hospital stays also showed no significant difference. Safety data, including adverse events and tolerability, were not reported in the source. The authors explicitly state that larger randomized controlled trials are necessary in the future to further clarify these findings.
View Original Abstract ↓
PurposeWe aim to evaluate the efficacy of local antibiotic delivery systems in patients with diabetic foot osteomyelitis (DFO).MethodsThe Web of Science, PubMed, and Embase databases were searched for relevant publications until March 2024. All studies evaluating the efficacy of local antibiotic delivery systems in patients with DFO were included. We calculated pooled risk ratio (RR) with 95% CIs for binary outcomes and mean difference (MD) for continuous outcomes. The Cochrane's risk of bias tool and methodological index for non-randomized studies (MINORS) assessment were used to evaluate the quality of studies.ResultsA total of 9 studies with 491 patients were included in this analysis. The overall healing rate in antibiotic group was 0.85 (95% CI: 0.67, 0.97). Healing rates were significantly higher in the antibiotic group compared to the control group (RR: 1.18, 95% CI: 1.01, 1.38). Furthermore, recurrence rates and amputation rates have no significantly difference between the antibiotic group and the control group (RR: 0.30, 95% CI: 0.04, 2.12 and RR: 0.22, 95% CI:0.03, 1.91), along with no significantly difference in healing time and hospital stays(MD: -7.87, 95% CI: -20.81, 5.07 and MD:-2.33, 95% CI:-5.17, 0.50). No obvious publication bias was observed in the funnel plot (Egger's test, = .99).ConclusionsOur meta-analysis found that diabetic foot osteomyelitis patients treated with local antibiotic delivery systems had better healing rates than the control group. However, no significant differences were found in healing time, recurrence, hospital stays, or amputation rates. Larger randomized controlled trials are necessary in the future.
Intrawound tobramycin plus vancomycin did not reduce deep infection risk compared with vancomycin alone in high-risk tibial fractures
Adding Antibiotics to Bone Surgery Didn't Lower Infection Risk
Related in Infectious Disease
Oral HPV detected in 27.9% of men living with HIV across Brazil, Mexico, and Puerto Rico
Oral HPV found in 28 percent of HIV-positive men in Brazil, Mexico, and Puerto Rico
This cross-sectional study examined 700 men living with HIV in Brazil, Mexico, and Puerto Rico. Oral HPV was detected in 27.9% of participan…
A cross-sectional study found oral HPV in 28 percent of men living with HIV across three countries, with higher rates linked to lower CD4 co…
Systemic corticosteroid therapy significantly decreased length of hospital stay and fever duration in children with community-acquired pneumonia
Shorter hospital stays and fever for kids with pneumonia using steroids
This systematic review and meta-analysis evaluated systemic corticosteroid therapy versus controls in children with community-acquired pneum…
A large review found that adding steroids to standard antibiotics helped children with pneumonia leave the hospital faster and get over thei…
Women's contraceptive preferences align with method use in Kenya; long-acting preference strongest
What women want in contraception: preferences predict use
This analysis of baseline data from an RCT in 2599 women living with HIV in Kenya found that preferences for long-acting methods, avoiding d…
Women in Kenya who preferred long-acting or self-discontinuation methods were more likely to use them, a study of 2,599 women finds.
F/TAF PrEP shows similar HIV incidence to F/TDF in cisgender women but noninferiority not proven
PrEP pill F/TAF shows similar HIV prevention as F/TDF in women
This RCT in 1380 predominantly cisgender women in East and South Africa compared daily oral F/TAF vs F/TDF for HIV PrEP over 6 months. HIV i…
A study in African women found that a newer PrEP pill (F/TAF) prevented HIV at similar rates to the standard pill (F/TDF), but the study was…
From Other Specialties
Higher EAT-Lancet diet adherence linked to lower risks of depression, anxiety, stroke, and dementia in observational cohorts
Eating healthy plant foods may lower risk of depression, anxiety, stroke, and dementia in older adults
This systematic review and meta-analysis examined associations between adherence to the EAT-Lancet diet and neuropsychiatric disorders acros…
A review of many studies found that following a plant-based diet like EAT-Lancet was linked to lower chances of depression, anxiety, stroke,…
Simulation-based training improves fundus identification success in ophthalmology education
Simulation training improves eye exam skills in early review
This systematic review and meta-analysis of 772 participants found that simulation-based training led to a 63.1% fundus identification succe…
A review of 772 participants found simulation training helped identify eye structures better than traditional methods, with most preferring …
ECMO cannulation by intensivists shows 2% per cannula and 5% per patient complication rates in a meta-analysis of 12 studies
Intensivists Can Safely Perform ECMO Cannulation, Review Finds
This systematic review and meta-analysis evaluated complication rates associated with ECMO cannulation performed by intensivists across 12 s…
A review of 12 studies finds intensivists can safely place ECMO lines, with low complication rates.
Kidney transplantation reduces left-ventricular mass index by 22 g/m² in end-stage kidney disease
Kidney transplant reverses heart damage in kidney disease patients
This meta-analysis of 33 observational studies (2364 patients) found that kidney transplantation significantly reduces left-ventricular mass…
A kidney transplant can reverse heart muscle thickening in end-stage kidney disease patients, new analysis shows.