Local Antibiotic Delivery Systems in Diabetic Foot Osteomyelitis: A Brief Review

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Abstract
The Review of Diabetics Studies,2021,17,2,75-81.
Published:October 2021
Type:Review Article
Authors:
Author(s) affiliations:

Christos Chatzipapas1, Makrina Karaglani1, Nikolaos Papanas2, Konstantinos Tilkeridis1, Georgios I. Drosos1

1Department of Orthopaedic Surgery, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.

2Diabetes Centre - Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.

Abstract:

Diabetic foot osteomyelitis (DFO) is a severe, difficult to treat infection. Local antibiotic delivery has been studied as a potential therapeutic adjunct following surgery for DFO. This review aims to summarize the evidence on local antibiotic delivery systems in DFO. PubMed database was searched up to March 2020. Overall, 16 studies were identified and included: 3 randomized controlled trials (RCTs), 3 retrospective studies (RSs), and 10 case series. In the RCTs, gentamicin-impregnated collagen sponges significantly improved clinical healing rates and slightly improved duration of hospitalization. In the RSs, antibiotic-impregnated calcium sulfate beads non-significantly improved all healing parameters, but did not reduce post-operative amputation rates or time of healing. The majority of case series used calcium sulfate beads, achieving adequate rates of healing and eradication of infection. In conclusion, evidence for add-on local antibiotic delivery in DFO is still limited; more data are needed to assess this therapeutic measure.