Rifampin Tied to Better Outcomes in Diabetic Foot Osteomyelitis

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Rifampin might be a more effective treatment for diabetic foot osteomyelitis than other antibiotics, suggests an observational study in JAMA Network Open.

Using Veterans Health Administration data, researchers identified patients who were prescribed antibiotics after being diagnosed with diabetic foot osteomyelitis. The 130 patients who were treated with adjunctive rifampin within 6 weeks of diagnosis were compared with 6000 who didn't receive rifampin.

In the 2 years after diagnosis, the combined outcome of foot amputations and mortality occurred less often in the rifampin group than in those receiving other antibiotics (27% vs. 37%). However, the authors note, rifampin patients were significantly younger, had fewer comorbidities, and had higher rates of S. aureus infection.

The authors conclude that their findings "suggest that adjunctive rifampin therapy may be a useful antimicrobial strategy in the treatment of [diabetic foot osteomyelitis]. A rigorous evaluation of its effects with a large interventional study is warranted."