Bone Biopsy vs. Ulcer Bed Culture in Managing Diabetic Foot Osteomyelitis

For microbiological assessment of diabetic foot osteomyelitis (DFO) before antibiotic selection, percutaneous or surgical bone biopsy is the gold standard, but ulcer bed cultures often are more practical in real-world settings. In a multicenter, double-blind trial, 84 adults with DFO who were not severely immunocompromised and not receiving antibiotics underwent both bone and ulcer bed biopsies for culture. Participants were randomly assigned to receive antibiotics based on either the bone or ulcer culture results.