Lesens O, Desbiez F, Theïs C, Ferry T, Bensalem M, Laurichesse H, Tauveron I, Beytout J, Aragón Sánchez J, Working Group on Diabetic Osteomyelitis., et al.
The international journal of lower extremity wounds. Date of publication 2015 Sep 1;volume 14(3):284-90.
1. Int J Low Extrem Wounds. 2015 Sep;14(3):284-90. doi: 10.1177/1534734614559931.
Epub 2014 Dec 16.
Staphylococcus aureus-Related Diabetic Osteomyelitis: Medical or Surgical
Management? A French and Spanish Retrospective Cohort.
Lesens O(1), Desbiez F(2), Theïs C(3), Ferry T(4), Bensalem M(5), Laurichesse
H(3), Tauveron I(6), Beytout J(3), Aragón Sánchez J(7); Working Group on Diabetic
Osteomyelitis.
Author information:
(1)Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied,
Clermont-Ferrand, France olesens@chu-clermontferrand.fr.
(2)Service d'endocrinologie Hôpital Gabriel Montpied, Clermont-Ferrand, France.
(3)Service des maladies infectieuses et tropicales Hôpital Gabriel Montpied,
Clermont-Ferrand, France.
(4)University of Lyon Claude Bernard, Lyon, France Croix-Rousse Hospital,
Hospices Civils de Lyon, Lyon, France.
(5)Centre hospitalier d'Annecy, Metz-Tessy, France.
(6)University of Lyon Claude Bernard, Lyon, France.
(7)La Paloma Hospital, Las Palmas de Gran Canaria, Spain.
Staphylococcus aureus is the main cause of diabetic foot osteomyelitis (DFO) and
can be treated medically or by surgery. We investigated the outcome of
consecutive patients with a diagnosis of S aureus DFO retrospectively in 4
hospitals according to the type of management, medical (including debridement at
bedside) or surgical. The outcome was classified as either favorable or failure
(relapse, impaired wound healing, or amputation). Seventy-four patients with S
aureus DFO, including 26 with methicillin-resistant S aureus, were included with
a mean duration of follow-up of 21 ± 1 months. As part of the initial treatment,
47% underwent bone surgery followed with a short course of antibiotic. Others
were treated with antibiotic therapy alone with bedside debridement. The outcome
was favorable for 84% of these patients, with similar rates in the surgical and
medical groups (80% vs 87%, P > .05). Patients in the medical group were less
frequently hospitalized (49% vs 94%, P < .001) and had a shorter length of
hospital stay (17 ± 3 vs 50 ± 12 days, P = .004). Patients in the surgery group
received a shorter course of antibiotic therapy (10 ± 2 vs 11 ± 1 weeks, P =
.001) with fewer side effects (9% vs 33%, P = .01). The type of management was
not associated with subsequent new episode of noncontiguous DFO, which developed
in 32% of cases. In conclusion, except significant differences in duration of
hospitalization and antibiotic therapy, medical and surgical management of S
aureus DFO had similar outcomes with a cure rate >80%.
© The Author(s) 2014.
DOI: 10.1177/1534734614559931
PMID: 25515373 [Indexed for MEDLINE]
