Systemic antibiotics for diabetes mellitus‐related foot infections: an integrative literature review

Abstract Evidence on antibiotic therapy for diabetic foot infections can help clinical management. The objective of this study was to identify the evidence on systemic antibiotics for treatment of diabetes mellitus-related foot infections. An integrative literature review was conducted of randomized clinical trials, systematic reviews, and meta-analyses. The keywords “Diabetic foot” AND “Antibiotics” were used to search PubMed and 15 articles were selected (nine randomized clinical trials, four systematic reviews, and two meta-analyses). Seven randomized clinical trials revealed clinical results that were comparable for beta lactam antibiotics with beta-lactamase inhibitors, carbapenems, and fluoroquinolones. Two randomized clinical trials found significant differences comparing ertapenem and tigecycline and in analyses of subsets with severe infections between piperacillin-tazobactam and ertapenem. The literature revealed comparable clinical results for different systemic antibiotics used to treat foot infections related to diabetes, except for the difference between ertapenem and tigecycline, which did not meet the parameters for non-inferiority, highlighting the need for higher-quality evidence.