Treatment of Osteomyelitis in the Diabetic Foot with Systemic and Locally Injected Antibiotics and the End-distolic Pneumatic Compression Boot—Case Studies

Abstract

The treatment of 35 patients for 42 episodes of osteomyelitis in the distal lower extremity is summarized and the long-term courses of 3 patients are illustrated in detail. Systemic antibiotics were used both to help control infection in the foot and to prevent septic emboli. The systemic antibiotics were given by the oral route alone (16 episodes), by the parenteral route alone (4 episodes), or by both oral and parenteral routes (22 episodes). Local foot treatments included injections of antibiotics into the infected areas of the foot, multielectrolyte-antibiotic foot soaks, and the end-diastolic pneumatic compression boot. X-ray evidence of osteomyelitis was found one to four weeks after it was clinically suspected and was associated with an improvement in the clinical status of the foot. Osteomyelitis was not considered an indication for amputation. The osteomyelitis lesions healed and foot structure and function were maintained.