A systematic review and meta-analysis of randomized controlled trials of systemic antibiotics for diabetes-related foot infections
Abstract
Objective: Diabetes-related foot infections (DFIs) are prevalent in patients with diabetes mellitus, often leading to severe complications, including amputations. This study aims to assess the efficacy and safety of systemic antibiotics in DFI treatment.
Research design and methods: A systematic review was conducted by searching PubMed, Cochrane databases, and Embase for randomized controlled trials up to August 4, 2024, evaluating the clinical efficacy of systemic antibiotics for DFIs. Primary outcomes were clinical efficacy and safety, comparing different antibiotic classes to penicillins. Subgroup analysis was based on DFI severity.
Results: Of 24 studies, 16 were included in the meta-analysis. Linezolid showed a potential efficacy advantage over penicillins for DFIs but had more adverse effects. Clinical efficacy and safety were comparable across carbapenems and quinolones versus penicillins. Ertapenem showed no significant difference from piperacillin/tazobactam in treating moderate or severe DFIs.
Conclusion: In conclusion, while linezolid may offer a potential efficacy advantage over penicillins in treating DFIs, it is associated with a higher risk of drug-related adverse effects. Penicillins demonstrate comparable clinical efficacy and safety to carbapenems and fluoroquinolones for DFI management. For moderate to severe DFIs, piperacillin/tazobactam and ertapenem are viable options, though treatment should be guided by local antimicrobial resistance patterns.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Photochemical behavior of levofloxacin
- Correlation Between Dissolution Profiles of Salt-Form Drugs in Biorelevant Bicarbonate Buffer and Oral Drug Absorption: Importance of Dose/ Fluid Volume Ratio
- Evaluation of the synergistic potential and mechanisms of action for de novo designed cationic antimicrobial peptides
- Synthesis of [11C]levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.