Evaluating diagnostic tools, outcome measures and antibiotic approach in diabetic foot osteomyelitis: a scoping review and narrative synthesis.

Abstract

INTRODUCTION Diabetic foot osteomyelitis (DFO) is a significant complication of diabetic foot disease, however diagnosis remains challenging and treatment success is difficult to ascertain. Literature in this space has utilized varying diagnostic criteria and ideal outcome measures for success is unclear. AREAS COVERED This scoping review assesses methods of diagnosis of DFO and definitions of treatment outcomes in literature assessing antibiotic therapy for treatment of DFO. EXPERT OPINION There is a lack of consensus in design of diabetic foot trials, resulting in difficulty for clinicians to assess and manage serious conditions such as DFO. Cure of DFO is challenging to ascertain and treatment failure may be a better approach to assess outcomes in research assessing efficacy of antibiotic therapy. In the absence of gold standard diagnostic tools, practical approaches to outcome assessment may allow for greater clinical applicability of available data.