Do Anti-Biofilm Antibiotics Have A Place in the Treatment of Diabetic Foot Osteomyelitis? @ALPSlimb #ActAgainstAmputation

Here is a copy of a preprint from our long-time friend and colleague Eric Senneville and coworkers. The choice of antibiotic regimens to use in patients presenting with diabetic foot osteomyelitis and their duration differs according to the situation. Antibiotics play a more important role in the medical option where no infected bone has been... Continue Reading →

Study: Outpatient Parenteral Antibiotic Therapy for Diabetic Foot Osteomyelitis in an Uninsured and Underinsured Cohort @LimbsandLungs @ALPSlimb #ActAgainstAmputation

This is a great addition from our SALSAmigo, Grady/Emory's ID supreme, Marcos Schechter. Background  Diabetic foot osteomyelitis (DFO) is usually treated with prolonged outpatient parenteral antibiotic therapy (OPAT). Evaluation and treatment of nonantibiotic aspects of DFO (eg, peripheral artery disease) are also recommended. There are limited data regarding OPAT practice patterns and outcomes for DFO. Methods  Single-center... Continue Reading →

Outcomes of short versus long duration of antibiotic therapy for residual osteomyelitis in surgically resected diabetic foot infection #ActAgainstAmputation @ALPSlimb

More data (this report from Motaganahalli and coworkers to support the likely contention that, in general, shorter may be better - or at very least not worse. Introduction: Optimal treatment duration for residual osteomyelitis (OM) post-amputation in diabetic foot infection (DFI) remains unclear, with resultant heterogeneity in prescribing noted in clinical practice. We aimed to identify... Continue Reading →

Surgery without postoperative antibiotic treatment in diabetic foot #osteomyelitis is not associated with recurrence or limb loss #ActAgainstAmputation @ALPSlimb

Compelling findings from our long-time SALSAmigo, the pride of Gran Canaria, Javier Aragon-Sanchez and coworkers Surgery without postoperative antibiotic treatment in diabetic foot osteomyelitis is not associated with recurrence or limb loss Not using antibiotics after surgical treatment of diabetic foot osteomyelitis was not associated with failure of the surgery, recurrences, or limb loss. Antibiotics... Continue Reading →

Meta-Analysis: Outcomes of Surgical and Medical Management of Diabetic Foot Osteomyelitis @UTSW_Plastics @UTSWOrtho

Subtle and compelling work from our toemigos Larry Lavery and Dane Wukich's team led by David Truong. Background. The aim of this study was to evaluate clinical outcomes in the published literature on medical and surgical management of diabetic foot osteomyelitis (DFO). Methods. A PubMed and Google Scholar search of articles relating to DFO was... Continue Reading →

Routine bacterial culture of proximal bone specimens during minor amputation in patients with DFI has little clinical utility in predicting re-operation or healing @ALPSlimb #ActAgainstAmputation #DiabeticFoot

Bone cultures? Clean margins for pathology? Both? These data from Voon and colleagues add more fuel to the discussionBackground: Trans-phalangeal and trans-metatarsal amputation, collectively termed 'minor amputations' are important procedures for managing infections of diabetes-related foot ulcers (DFU). Following minor amputation, international guidelines recommend a prolonged course of antibiotics if residual infected bone on intra-operative... Continue Reading →

Oral Is the New IV. Challenging Decades of Blood and Bone Infection Dogma: A Systematic Review @bradspellberg @lacuscmedcenter @usc

Superb work from Wald-Dickler and coworkers adding to the growing body of evidence that (to coin a phrase from senior author Brad Spellberg), shorter may be better and oral > IV. Background We sought to determine if controlled, prospective clinical data validate the long-standing belief that intravenous (IV) antibiotic therapy is required for the full... Continue Reading →

Application and Clinical Effectiveness of Antibiotic-Loaded Bone Cement in the Treatment of Neuropathic Diabetic Foot Ulcers Complicated by Osteomyelitis: A Randomized Controlled Trial

Intriguing work by Ehya and coworkers. Abstract This study explored the clinical effectiveness of antibiotic-loaded bone cement on primary treatment of diabetic foot infection. This is a randomized controlled study, including thirty-six patients with diabetic foot ulcer complicated by osteomyelitis who had undergone treatment between May 2018 and December 2019. Patients were randomly divided into... Continue Reading →

Using a BonE BiOPsy (BeBoP) to determine the causative agent in persons with diabetes and foot osteomyelitis: study protocol for a multicentre, randomised controlled trial @bradspellberg @limbsandlungs @alpslimb #ActAgainstAmputation

We look forward to this study and it's resultant findings from our good friend and colleague Edgar Peters and coworkers Diabetic foot osteomyelitis (DFO) poses a major disease burden. It can generally be treated with long-term antibacterial therapy. International guidelines recommend to base antibacterial therapy choices on percutaneous bone biopsy culture, while in practice, therapy... Continue Reading →

The Degree of Blood Supply and Infection Control Needed to Treat Diabetic Chronic Limb-Threatening Ischemia with Forefoot Osteomyelitis @USC_Vascular @JAPMAFeetTweets

untitled Miki Fujii, MD, PhD* Hiroto Terashi, MD, PhD† Koichi Yokono, MD, PhD‡ David G. Armstrong, DPM, MD, PhD§ Background: Diabetic foot ulcers combined with ischemia and infection can be difficult to treat. Few studies have quantified the level of blood supply and infection control required to treat such complex diabetic foot ulcers. We aimed... Continue Reading →

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