Adjunctive Rifampin for Diabetic Foot Osteomyelitis Appears to Increase Amputation-Free Survival #ActAgainstAmputation @BradSpellberg @USC @KeckMedUSC

Important initial work from Wilson and coworkers (including our friend and colleague Brad Spellberg) suggests that adjunctive rifampin may lead to more amputation-free survival in US Veterans with diabetic foot osteomyelitis. While more work is necessary to confirm or refute these data, it bears another look for all of us!

Key Points:

Question  What are the amputation and mortality outcomes of patients treated with and without adjunctive rifampin for diabetic foot osteomyelitis?

Findings  In this cohort study that analyzed 6174 veterans with diabetic foot osteomyelitis, a significantly lower rate of a combined amputation or mortality end point was observed in those treated with rifampin (26.9%) compared with those without rifampin (37.0%).

Meaning  Based on these findings, adjunctive rifampin may be a useful antimicrobial addition in the treatment of diabetic foot osteomyelitis, and a rigorous evaluation of its effect is warranted.

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