Cochrane · systematic review · CD011038
Topical antimicrobial agents for treating foot ulcers in people with diabetes
Dumville, JC, Lipsky, BA, Hoey, C, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
WoundsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
12
No studies
8
Included studies
NR
No studies 8 · 40%Ungraded 0 · 0%Very low 9 · 45%Low 2 · 10%Moderate 1 · 5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antimicrobial dressings compared with non‐antimicrobial dressings
Population: Foot ulcers in people with diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of wounds healed Up to 24 weeks' Antimicrobial dressings vs non‐antimicrobial dressings | RR 1.28 [1.12, 1.45] | 5 studies · 945 participants | Low Downgraded: risk of bias, imprecision |
Incidence of infection Up to 24 weeks' Antimicrobial dressings vs non‐antimicrobial dressings | RR 0.34 [0.04, 3.1] | 2 studies · 173 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Resolution infection Antimicrobial dressings vs non‐antimicrobial dressings | no estimate extracted | NR | No studies |
Adverse events Up to 24 weeks' Antimicrobial dressings vs non‐antimicrobial dressings | RR 0.96 [0.62, 1.48] | 1 study · 134 participants | Very low Downgraded: risk of bias, imprecision |
Topical antimicrobial agents (non‐dressing) compared with non‐antimicrobial topical agents (non‐dressing)
Population: Foot ulcers in people with diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of wounds healed Up to 24 weeks' Topical antimicrobial agents (non‐dressing) vs non‐antimicrobial topical agents (non‐dressing) | RR 2.82 [0.56, 14.23] | 3 studies · 112 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Incidence of infection Topical antimicrobial agents (non‐dressing) vs non‐antimicrobial topical agents (non‐dressing) | no estimate extracted | NR | No studies |
Resolution of infection Up to 24 weeks' Topical antimicrobial agents (non‐dressing) vs non‐antimicrobial topical agents (non‐dressing) | RR 1.16 [0.54, 2.51] | 1 study · 40 participants | Low Downgraded: imprecision |
Adverse events Up to 24 weeks' Topical antimicrobial agents (non‐dressing) vs non‐antimicrobial topical agents (non‐dressing) | no estimate extracted | 2 studies · 81 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
One topical antimicrobial agent compared with an alternative topical antimicrobial agent
Population: Foot ulcers in people with diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of wounds healed Up to 24 weeks' One topical antimicrobial agent vs an alternative topical antimicrobial agent | no estimate extracted | 3 studies · 85 participants | Very low Downgraded: risk of bias, imprecision |
Incidence of infection Up to 24 weeks' One topical antimicrobial agent vs an alternative topical antimicrobial agent | no estimate extracted | NR | No studies |
Resolution of infection Up to 24 weeks' One topical antimicrobial agent vs an alternative topical antimicrobial agent | RR 1.45 [0.97, 2.17] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Up to 24 weeks' One topical antimicrobial agent vs an alternative topical antimicrobial agent | no estimate extracted | 1 study · 41 participants | Very low Downgraded: risk of bias, imprecision |
Topical antimicrobial agent compared with systemic antimicrobial agent
Population: Foot ulcers in people with diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of wounds healed Topical antimicrobial agent vs systemic antimicrobial agent | no estimate extracted | NR | No studies |
Incidence of infection Topical antimicrobial agent vs systemic antimicrobial agent | no estimate extracted | NR | No studies |
Resolution of infection Topical antimicrobial agent vs systemic antimicrobial agent | RR 1.51 [0.91, 2.49] | 2 studies · 102 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Topical antimicrobial agent vs systemic antimicrobial agent | RR 0.91 [0.78, 1.06] | 4 studies · 937 participants | Moderate Downgraded: risk of bias |
Topical antimicrobial agent compared with growth factor
Population: Foot ulcers in people with diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Proportion of wounds healed Topical antimicrobial agent vs growth factor | RR 0.5 [0.28, 0.89] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Incidence of infection Topical antimicrobial agent vs growth factor | no estimate extracted | NR | No studies |
Resolution of infection Topical antimicrobial agent vs growth factor | no estimate extracted | NR | No studies |
Adverse events Topical antimicrobial agent vs growth factor | no estimate extracted | NR | No studies |