Comparison of the efficacy of six-week versus twelve-week antibiotic therapy for the treatment of nonsurgical diabetic foot osteomyelitis

Background: There is little evidence regarding the optimal duration of antibiotic therapy for diabetic foot osteomyelitis (DFO). So, the optimal duration of antibiotic treatment of osteomyelitis complicating foot wounds in non–surgically treated diabetic patients is currently unknown and needs more studies in the future. This study aimed to compare six-week versus twelve-week antibiotic therapy for the treatment of nonsurgical DFO. Methods: This was an interventional study that was performed on 30 patients with DFO without surgical indications who were randomly divided into two groups (six-week versus twelve-week antibiotic therapy). Changes of parameters such as C-reactive protein (CRP), albumin, erythrocyte sedimentation rate (ESR), HbA1c, creatinine, fasting blood sugar (FBS) at baseline, FBS after two hours, white blood cell (WBC), absolute count of neutrophil and clinical outcomes (percentage of complete healing and non-healing, the time of complete healing, radiological abnormality and recurrence of the disease after treatment) were measured in the two groups and then analyzed by statistical methods in SPSS version 21. Results: During the study period, values of CRP (p=0.03), ESR (p=0.03), two-hour glucose (p=0.02), WBC (p=0.04) and absolute neutrophil count (p=0.04) in the six-week treatment group and the values of CRP (p=0.02), ESR (p=0.02), HbA1c (p=0.04), FBS at baseline (p=0.04), FBS after two-hour (p=0.01), WBC (p=0.02) and absolute neutrophil count (p=0.04) in the twelve-week treatment group changed significantly. There was no significant difference concerning the clinical outcomes between the two groups. Conclusions: The results showed that six and twelve-week antibiotic therapy had the same efficacy in the treatment of non-surgically DFO. Therefore, six-week antibiotic therapy of DFO could be sufficient in these patients.