Antibiotics and treatment duration in diabetic foot osteomyelitis

Andrew Boulton

What antibiotics and therapy duration are recommended in patients with diabetic foot osteomyelitis?

Andrew Boulton: That is a very pertinent question because for years we have been saying that localized osteomyelitis can be treated with antibiotics alone. You do not need surgery in every case. And it has been anecdotal until just a couple of years ago, when a nice trial from Spain randomized patients with localized osteomyelitis to antibiotics alone or surgery. The outcome was the same in each group, so you can use antibiotics alone. Then, subsequently, there was a study from France that suggests – whereas we always said you probably need 2 to 3 months – that probably 6 weeks is sufficient. That was another good study from France published just in the last 2 years.

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