Introduction and Objective: Bedside Blind Bone Biopsy (B4) recommendations, as an alternative diagnosis tool to conventional biopsy in case of suspected Diabetic Foot Ulcer (DFU) osteitis, relies on still limited data. To assess the healing outcome related to microbial-culture results in bone samples collected by B4, we perform a larger study than previously published. Methods: A 10-years observational study was conducted in our Diabetes Unit (12.2015-11.2024). B4 was performed ≥2 weeks after antibiotics discontinuation in every patient admitted for a DFU with clinical and/or radiological suspicion osteitis requiring no surgery. We compared DFU outcome between osteitis microbial-culture proven (B4+) and negative microbial-culture (B4-). All patients received offloading, wound care ± revascularization. A 6-weeks targeted antibiotherapy was indicated for proven osteitis (B4+). No antibiotherapy was administered in B4-. The primary outcome was complete DFU healing at 6 months. Results: Among 1330 consecutive patients admitted for DFU, 310 (23%) met the inclusion criteria. Patients characteristics and results are summarized in table 1. Regardless of microbial results, complete DFU healing was achieved in nearly 2/3 of patients. Conclusion: Our large study cohort confirms that B4 allows early and appropriate medical strategies for DFU with suspected osteitis. It indicates targeted antibiotherapy for B4+ patients while it avoids unnecessary treatments for B4-. Disclosure F. Feron: None. J. Julla: Board Member; Current; Sanofi. Consultant; Current; Sanofi, IQVIA Inc. Other - Speaker; Ended; Novo Nordisk. Other - Facility; Ended; Lilly Diabetes. J. Riveline: Consultant; Current; Abbott, Ypsomed AG, Lilly, Novo Nordisk, Sanofi, Dexcom, Inc., Insulet Corporation, Medtronic, Air Liquide International. J. Gautier: None. J. Kevorkian: None.
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