Field: Medicine › Endocrinology, Diabetes and MetabolismType: No effect foundArea: infectious disease and diabetic foot careTarget: Topical gentamicin-collagen sponge added to systemic antibioticsStage: randomized trial
Hypothesis
Adding a topical gentamicin-collagen sponge to systemic antibiotic therapy would improve healing of moderate or severe diabetic foot ulcer infections.
What failed
Across 88 randomized infection episodes, final clinical cure was 31/43 with the sponge against 26/45 without (p = 0.16), and in multivariate analysis adjusted for case mix the sponge was not associated with cure or improvement.
Broken assumption
Delivering an antibiotic locally into the wound adds to what systemic therapy already achieves.
Why
The authors report excellent tolerability with no attributed adverse events and only a trend towards more rapid healing, and draw no mechanistic conclusion.
From the published paper: Uçkay et al. BMC Infectious Diseases, 2018. ↗CC BY