TRIP

Better evidence needed to guide the treatment of diabetic foot infections

The Diabetes Elf, 2012

Foot infections are common in diabetes.  This systematic review compared different approaches to treating soft tissue and bone infections in diabetic patients’ feet.
This was not clearly stated in the abstract and should be assessed carefully in appraising the applicability of this evidence to your situation.
The reviewers found 33 studies, of which 29 were randomized controlled trials and four were cohort studies.
They included studies on different antibiotics drugs, regimens and delivery modes, surgery, superoxidised water, granulocyte-colony stimulating factor and hyperbaric oxygen.
All but one of the studies on antibiotics found no difference between treatment types.  Some studies reported better outcomes for surgery in preventing amputation, but these were considered of low quality.
Does this review address a clearly focused question, in terms of patient population, interventions and outcomes.
Finding better quality systematic reviews or individual trials that are more directly relevant to your setting.
, which includes guidelines.  Although the site is supported by the International Diabetes Federation, it is not clear about its funding or the guidelines development methods.