Bone biopsy not superior to ulcer bed biopsy guided antibacterial therapy on remission of diabetic foot osteomyelitis: A randomized controlled trial

This study aimed to compare 12-month outcomes of conservatively treated DFO patients whose antibiotic regimens were based on either bone or ulcer bed biopsy.
 Methods: We conducted a multicenter, double-blind randomized clinical trial in 84 adult participants with DFO. DFO remission was assessed at 12 months.
 Results: The remission rate in the bone biopsy group was 31,4% (95% CI 18,1-48,7%) and 39.4% (95% CI 24,2-57,0%) in the ulcer bed biopsy group. The RR of not achieving remission at 12 months in the bone biopsy group was 1.13; (95%CI 0.80-1.60) in the ITT analyses.
 Conclusions: This study found no evidence to advise bone biopsies prior to the start of antibiotics in patients with DFO.