{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:43:08Z","timestamp":1778733788417,"version":"3.51.4"},"reference-count":65,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Health, National Institute of Diabetes, and Digestive and Kidney Diseases","award":["1R01124789-01A1"],"award-info":[{"award-number":["1R01124789-01A1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Osteomyelitis is a severe complication of diabetes-related foot ulcers (DFUs) often managed with antibiotic therapy and surgical resection of the infected bone. Areas of research: While intravenous (IV) antibiotics have been the traditional approach for bone and joint infections in general, randomized clinical trials have shown that, overall, oral antibiotics are non-inferior to IV antibiotics. While comparisons between oral antibiotics are generally lacking, the data suggest that oral antibiotics with high bioavailability and bone penetration ratios should be prioritized for osteomyelitis treatment, including diabetic foot osteomyelitis (DFO). Oral regimens reduce hospital stays, avert catheter-related complications, and decrease treatment costs while improving patient satisfaction and quality of life. Despite these advantages, IV antibiotics remain widely used, partly due to clinical tradition and concerns about oral absorption in individuals with diabetes. Current guidelines recommend transitioning to oral therapy once systemic signs improve, but robust data supporting oral-only regimens for DFO treated non-surgically remain limited. Conclusions: Oral antibiotics represent a safe and effective alternative to IV therapy for many patients with DFO, particularly when high-bioavailability agents are used. Further well-designed studies are needed to validate their efficacy in non-surgical DFO management and inform clinical guidelines.<\/jats:p>","DOI":"10.3390\/jcm14051405","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T04:03:17Z","timestamp":1740024197000},"page":"1405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Not All in Vein: Oral Antibiotics for Diabetic Foot Osteomyelitis: A Narrative Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Benoit","family":"Gachet","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Gustave Dron Hospital, F-59200 Tourcoing, France"},{"name":"French National Referent Centre for Complex Bone and Joint Infections, CRIOAC Lille-Tourcoing, F-59000 Lille, France"},{"name":"EA2694, Lille University, F-59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos C.","family":"Schechter","sequence":"additional","affiliation":[{"name":"Grady Memorial Hospital, Atlanta, GA 30303, USA"},{"name":"Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA 30322, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David G.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90007, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8196-5442","authenticated-orcid":false,"given":"Olivier","family":"Robineau","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Gustave Dron Hospital, F-59200 Tourcoing, France"},{"name":"French National Referent Centre for Complex Bone and Joint Infections, CRIOAC Lille-Tourcoing, F-59000 Lille, France"},{"name":"EA2694, Lille University, F-59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5720-8908","authenticated-orcid":false,"given":"Eric","family":"Senneville","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Gustave Dron Hospital, F-59200 Tourcoing, France"},{"name":"French National Referent Centre for Complex Bone and Joint Infections, CRIOAC Lille-Tourcoing, F-59000 Lille, France"},{"name":"EA2694, Lille University, F-59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1111\/dme.13935","article-title":"Systematic review of randomized controlled trials on antibiotic treatment for osteomyelitis in diabetes","volume":"36","author":"Xing","year":"2019","journal-title":"Diab. 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