Diabetic Foot Osteomyelitis
Conditions
Keywords
Diabetic foot, Osteomyelitis, Antibiotic treatment, White Blood Cell SPECT/CT
Brief summary
Osteomyelitis is a risk factor for lower extremity amputation in diabetic people. Antibiotic therapy allows a remission in 60 to 80% of cases. However the optimal duration of antibiotic therapy remains controversy due to the absence of validated marker of osteomyelitis remission. We have previously shown that the negativity of white blood cell SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) imaging at the end of treatment allowed to predict remission of osteomyelitis at 1 year in all cases. A positive imaging was associated with recurrence in 70% of cases. The aim of our study was to evaluate prospectively the interest of white blood cell SPECT/CT to set the duration of antibiotic therapy.
Interventions
OTHERwhite blood cell SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography) imaging
Sponsors
Hospices Civils de Lyon
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \>18 years * Diabetes * Osteomyelitis defined by soft tissue infection and/or positive probe-to-bone test and suggestive signs of osteomyelitis on plain-X-Ray
Exclusion criteria
\- Indication for acute surgical bone resection or amputation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of remission of osteomyelitis at one year after the cessation of antibiotic treatment, evaluated by white blood cell SPECT/CT (Single Photon Emission Computed Tomography/Computed Tomography). | one year after the end of the antibiotic treatment | The outcome measure was reviewed by patient examination at least 12 months after completion of antibiotic treatment. A remission was defined by : * the absence of recurrent infection at the initial site * no need for surgical bone resection or amputation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of osteomyelitis remission at one year after a 6 weeks antibiotics duration, evaluated by white blood cell SPECT/CT | one year after the end of the antibiotic treatment | The outcome measure was reviewed by patient examination at least 12 months after completion of antibiotic treatment. A remission was defined by : * the absence of recurrent infection at the initial site * no need for surgical bone resection or amputation |
| Sensibility ration of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | one year after the end of the antibiotic treatment | Sensibility ratio= number of true positive /number of (true positive+false negative) |
| Specificity ratio of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | one year after the end of the antibiotic treatment | Specificity ratio= number of true negative /number of (true negative+false positive) |
| Positive predictive value of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | one year after the end of the antibiotic treatment | Positive predictive value = number of true positive / number of (true positive+false positive) |
| Negative predictive value of White Blood Cell SPECT/CT performed at the end of antibiotic treatment to predict the remission of osteomyelitis at one year. | one year after the end of the antibiotic treatment | Negative predictive value = number of true negative / number of (true negative+false negative) |
Countries
France
Contacts
Primary ContactJulien Vouillarmet, MD
Outcome results
None listed