***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Little is known about the optimal duration of antibiotic therapy for diabetic foot osteomyelitis ( DFO ) . This study sought to compare the effectiveness of 6 versus 12 weeks of antibiotic therapy in patients with DFO treated nonsurgically ( i.e. ,  antibiotics alone ) . RESEARCH DESIGN AND METHODS This was a prospect i ve r and omized trial comparing 6- versus 12-week duration of antibiotic treatment .  Remission of osteomyelitis during the monitoring period was defined as complete and persistent ( > 4 weeks ) healing of the wound ( if present initially ) , absence of recurrent infection at the initial site or that of adjacent rays , and no need for surgical bone resection or amputation at the end of a follow-up period of at least 12 months after completion of antibiotic treatment . RESULTS Forty patients followed at five French general hospitals were r and omized between January 2007 and January 2009 , with 20 treated for 6 weeks and 20 treated for 12 weeks with antibiotics  . The two groups were comparable for all variables recorded at inclusion in the study . Remission was obtained in 26 ( 65 % ) patients , with no significant differences between patients treated for 6 versus 12 weeks ( 12/20 vs. 14/20 , respectively ; P = 0.50 ) . We did not identify any significant parameters associated with patient outcome . Fewer patients treated for 6 weeks experienced gastrointestinal adverse events related to antimicrobial therapy compared with patients treated for 12 weeks ( respectively , 15 vs. 45 % ; P = 0.04 ) . CONCLUSIONS The present multicenter prospect i ve r and omized study provides data suggesting that 6-week duration of antibiotic therapy may be sufficient in patients with DFO for whom nonsurgical treatment is considered A phase 3 , r and omized , double-blind trial was conducted in subjects with diabetic foot infections without osteomyelitis ( primary study ) or with osteomyelitis ( sub study ) to determine the efficacy and safety of parenteral ( intravenous [ iv ] ) tigecycline ( 150 mg once-daily ) versus 1 g once-daily iv ertapenem ± vancomycin .  Among 944 subjects in the primary study who received ≥1 dose of study drug , > 85 % had type 2 diabetes ; ~90 % had Perfusion , Extent , Depth/tissue loss , Infection , and Sensation infection grade 2 or 3 ; and ~20 % reported prior antibiotic failure . For the clinical ly evaluable population at test-of-cure , 77.5 % of tigecycline- and 82.5 % of ertapenem ± vancomycin-treated subjects were cured . Corresponding rates for the clinical modified intent-to-treat population were 71.4 % and 77.9 % , respectively . Clinical cure rates in the sub study were low ( < 36 % ) for a subset of tigecycline-treated subjects with osteomyelitis . Nausea and vomiting occurred significantly more often after tigecycline treatment ( P = 0.003 and P < 0.001 , respectively ) , result ing in significantly higher discontinuation rates in the primary study ( nausea P = 0.007 , vomiting P < 0.001 ) . In the primary study , tigecycline did not meet criteria for noninferiority compared with ertapenem ± vancomycin in the treatment of subjects with diabetic foot infections BACKGROUND This r and omized , prospect i ve , multicenter , open-label study was design ed to test whether a topical , electrolyzed , superoxidized solution ( Microcyn Rx ) is a safe and effective treatment for mildly infected diabetic foot ulcers . METHODS Sixty-seven patients with ulcers were r and omized into three groups . Patients with wounds irrigated with Microcyn Rx alone were compared with patients treated with oral levofloxacin plus normal saline wound irrigation and with patients treated with oral levofloxacin plus Microcyn Rx wound irrigation . Patients were evaluated on day 3 , at the end of treatment on day 10 ( visit 3 ) , and 14 days after completion of therapy for test of cure ( visit 4 ) . RESULTS In the intention-to-treat sample at visit 3 , the clinical success rate was higher in the Microcyn Rx alone group ( 75.0 % ) than in the saline plus levofloxacin group ( 57.1 % ) or in the Microcyn Rx plus levofloxacin group ( 64.0 % ) . Results at visit 4 were similar . In the clinical ly evaluable population , the clinical success rate at visit 3 ( end of treatment ) for patients treated with Microcyn Rx alone was 77.8 % versus 61.1 % for the levofloxacin group . The clinical success rate at visit 4 ( test of cure ) for patients treated with Microcyn Rx alone was 93.3 % versus 56.3 % for levofloxacin plus saline-treated patients . This study was not statistically powered , but the high clinical success rate ( 93.3 % ) and the P value ( P = .033 ) suggest that the difference is meaningfully positive for  Microcyn Rx-treated patients . CONCLUSIONS Microcyn Rx is safe and at least as effective as oral levofloxacin for mild diabetic foot infections Abstract Aims /hypothesis . To re-evaluate the use of Granulocyte-Colony Stimulating Factor ( G-CSF ) in the treatment of infected diabetic foot ulcers . Methods . Thirty-seven diabetic subjects were r and omised to Granulocyte-Colony Stimulating Factor ( G-CSF ) ( n=20 ) or placebo ( n=17 ) . The primary endpoint was resolution of cellulitis , which was evaluated clinical ly and with an infection summary score . Patients were hospitalised for 10 days and received subcutaneously either 5 µg/kg G-CSF or placebo daily . Ulcers were treated with a st and ard wound protocol and the patients were instructed to stay in bed . All subjects received antibiotics ( clindamycin and ciprofloxacin ) intravenously until the inflammation had subsided . Results . Patients who received G-CSF did not have an earlier resolution of clinical ly defined cellulitis ( p=0.57 ) . The infection summary score declined , but comparably , in both groups ( G-CSF : 29.5±18.4 to 6.7±6.3 p<0.001 , placebo : 24.2±16.9 to 8.9±7.2 p<0.001 ) . The ulcer volume , which was not greater among placebo patients , was reduced by 59 % in G-CSF and by 35 % in placebo patients . Conclusion /interpretation . We conclude that antibiotic and non weight-bearing therapy ( bed rest ) accelerated the resolution of cellulitis in infected foot ulcers . Additional treatment with G-CSF had no further beneficial effect This study tested whether levofloxacin , at a new high dose of 750 mg , was effective for the treatment of  complicated skin and skin-structure infections ( SSSIs ) . Patients with complicated SSSIs ( n=399 ) were r and omly assigned in a ratio of 1:1 to 2 treatment arms : levofloxacin ( 750 mg given once per day intravenously [ iv ] , orally , or iv/orally ) or ticarcillin-clavulanate ( TC ; 3.1 g given iv every 4 - 6 hours ) followed , at the investigator 's discretion , by amoxicillin-clavulanate ( AC ; 875 mg given orally every 12 hours ) . In the clinical ly evaluable population , therapeutic equivalence was demonstrated between the levofloxacin and TC/AC regimens ( success rates of 84.1 % and 80.3 % , respectively ) . In the microbiologically evaluable population , the overall rate of eradication was 83.7 % in the levofloxacin treatment group and 71.4 % in the TC/AC treatment group ( 95 % confidence interval , -24.3 to -0.2 ) . Both levofloxacin and TC/AC were well tolerated . These data demonstrate that levofloxacin ( 750 mg once per day ) is safe and at least as effective as TC/AC for complicated SSSIs OBJECTIVE To investigate the change of bacterial load applied with iodophors and rivanol of  diabetic foot ulcers ( DFUs ) , furthermore to evaluate the effect of both in removing superficial microbes of DFUs . METHODS From March 2006 to March 2007 , 30 patients were r and omly divided into control group ( group A , n = 10 ) ,  iodophor group ( group B , n = 10 ) and  rivanol group ( group C , n = 10 ) . There were 18 males and 12 females with an average age of 59.8 years ( range 46 - 78 years ) . The wound size ranged from 3 cm x 2 cm to 15 cm x 10 cm . The disease course was 6 weeks to 6 months ( mean 2.1 months ) . Each wound was debrided and irrigated before process , then drug was compressed on the wound for 5 minutes , and irrigated again . The sample s gained for three times , before , immediately and 24 hours after the process . Each sample was diluted before cultivation , the bacteria of wound were counted and compared among 3 groups . RESULTS The cultures of specimens showed that the load decreased in every group , each cultured colony of specimen grew well , and there were no significant differences between 3 groups immediately after procedure ( P > 0.05 ) . There were significant differences between group B and groups A , C ( P < 0.05 ) , but there were no significant difference between group A and group C 24 hours after treatment ( P > 0.05 ) . CONCLUSION Both iodophors and rivanol could remove the bacteria on the surface of wound . Topical germicide could reduced bacterial load in the wound of diabetic foot , the role of sterilizing and bacteriostasis of iodophors were better than that of rivanol Background Chronic foot ulcers in diabetes are serious , costly and frequently difficult to heal . Recent guidelines conclude that new dressings and treatments generally fail to show superiority compared with st and ard of care . Several mechanisms are probably responsible for impaired healing of chronic foot ulcers , including inflammation and infection . Chloramines have presumed antiseptic and antibacterial properties , and have shown to be a useful treatment in odontology . Methods In an explorative open r and omised controlled multi-centre study , we compared chloramine-based treatment with current st and ard of care for 12 weeks and follow-up for 24 weeks . Seventeen patients in each group , mean age about 70 , duration of diabetes > 20 years and foot ulcers about 1.5 years , completed the 12 weeks study . Results After 5 weeks , the difference between the groups in relative reduction in ulcer area was statistically significant ( p=0.016 ) . Absolute change in ulcer area was first statistically significant within the chloraminetreated group after 2 weeks ( p=0.026 ) , after 8 weeks in the control group ( p=0.0023 ) , with significant difference between groups after 5 weeks ( p=0.024 ) . The approximate relative decrease per week was 19.4 % ( 95%CI 12.2 , 26.0 ; p<0.0001 ) in the chloramine-treated group and 11.7 % ( 95%CI 6.4 , 16.7 ; p<0.0001 ; between-group difference p=0.083 ) . After 9 weeks 7 patients had healed in the chloraminetreated group , but only one in the control group ( p=0.039 ) . There were no statistically significant differences in wound healing at 12 or 24 weeks , and no marked differences in signs of infection , pain , quality of life ( EQ-5D ) , or incidence of adverse events . Conclusions Chloramine-based treatment seems to be efficacious , particularly in the early phase of the care of infected diabetic foot ulcers . It is safe and easy to use , and could prove to be a valuable addition in the treatment arsenal , providing non-surgical debridement . Future studies will evaluate its role in wound care BACKGROUND The aim of this pilot study was to determine the safety and potential benefit of adding a topical gentamicin-collagen sponge to st and ard of care ( systemic antibiotic therapy plus st and ard diabetic wound management ) for treating diabetic foot infections of moderate severity . METHODS We r and omized 56 patients with moderately infected diabetic foot ulcers in a 2:1 ratio to receive st and ard of care plus the gentamicin-collagen sponge ( treatment group , n = 38 ) or st and ard of care only ( control group , n = 18 ) for up to 28 days of treatment . Investigators performed clinical , microbiological , and safety assessment s at regularly scheduled intervals and collected pharmacokinetic sample s from patients treated with the gentamicin-collagen sponge . Test of cure was clinical ly assessed 14 days after all antibiotic therapy was stopped . RESULTS On treatment day 7 , we noted clinical cure in no treatment patients and three control patients ( P = .0 
    Output:
    
Thus , our systematic review revealed little evidence upon which to make recommendations for treatment of DFIs .