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Although the best strategy for managing osteomyelitis associated with diabetic foot ulcers is unclear, some data suggest that antimicrobial therapy without surgery can be effective when the choice of antibiotics is guided by bone-culture results. However, bone biopsies are infrequently performed. Might culture of needle-puncture specimens provide the needed information? To find out, researchers in France performed a prospective study comparing culture results for transcutaneous bone-biopsy, needle-puncture, and ulcer-swab specimens from 31 patients with diabetic foot ulcers and evidence of underlying osteomyelitis.
Twenty-one (68%) of the bone-biopsy cultures were positive, compared with 18 (58%) of the needle-puncture cultures and 30 (97%) …