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When osteomyelitis complicates diabetic foot infections, amputation or aggressive surgical debridement usually is recommended. When neither of these options is possible, prolonged antibiotic courses are substituted. Unfortunately, no one knows exactly how long a course is long enough.
Researchers in France randomized 40 diabetic adults with biopsy-confirmed osteomyelitis of the foot to treatment with either 6 or 12 weeks of antibiotics alone, without surgery. Most patients had infection of one of the metatarsal heads. Antibiotic selection was dictated by culture results of biopsy specimens, and antibiotics were administered orally for all but the first few days of treatment. No patient had evidence of vascular disease, none had gangrene, and…