ArticlePloS one2020
Susceptibility of monomicrobial or polymicrobial biofilms derived from infected diabetic foot ulcers to topical or systemic antibiotics in vitro.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 33 citations in OpenAlex.
- Bacteriophage therapy for antimicrobial-resistant, biofilm‑associated diabetic foot infection: delivery routes, phage antibiotic synergy, and practical wound‑care integration.Archives of microbiology · 2026Review
- Integrated analysis of the diabetic foot ulcer microbiome and host transcriptome supports a microenvironment-microbiota-host repair framework.Endocrine · 2026Article
- Different aspects of Pseudomonas aeruginosa biofilm: an in-depth analysis from formation to detection.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
- Biofilm Resilience: Molecular Mechanisms Driving Antibiotic Resistance in Clinical Contexts.Biology · 2025Review
- Antimicrobial Peptides: A Promising Alternative to Conventional Antimicrobials for Combating Polymicrobial Biofilms.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Review
- The Use of Photoactive Polymeric Nanoparticles and Nanofibers to Generate a Photodynamic-Mediated Antimicrobial Effect, with a Special Emphasis on Chronic Wounds.Pharmaceutics · 2024Review
- Article
- Visible label-free detection of bacterial DNA using flocculation of sterically stabilised cationic latexes.Journal of materials chemistry. B · 2023Article
- Improving the Management and Treatment of Diabetic Foot Infection: Challenges and Research Opportunities.International journal of molecular sciences · 2023Review
- Isolation and Characterization of Bacteriophages Active againstArchives of Razi Institute · 2022Article
- Association between hemoglobin A1c, Vitamin C, and microbiome in diabetic foot ulcers and intact skin: A cross-sectional study.Health science reports · 2022Article
- Biofilms in Diabetic Foot Ulcers: Impact, Risk Factors and Control Strategies.International journal of molecular sciences · 2021Review
- Review
- Efficacy of Topical Vancomycin- and Gentamicin-Loaded Calcium Sulfate Beads or Systemic Antibiotics in Eradicating Polymicrobial Biofilms Isolated from Diabetic Foot Infections within anAntimicrobial agents and chemotherapy · 2021Article
- Silver Sulfadiazine Eradicates Antibiotic-TolerantJournal of clinical medicine · 2020Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Diabetic foot ulcers can become chronic and non-healing despite systemic antibiotic treatment. The penetration of systematically-administered antibiotics to the site of infection is uncertain, as is the effectiveness of such levels against polymicrobial biofilms. We have developed an in vitro model to study the effectiveness of different treatments for infected diabetic foot ulcers in a wound-like environment and compared the activity of systemic levels of antibiotics with that for topically applied antibiotics released from calcium sulfate beads. This is the first study that has harvested bacteria from diabetic foot infections and recreated similar polymicrobial biofilms to those present in vivo for individual subjects. After treatment with levels of gentamicin attained in serum after systemic administration (higher than corresponding tissues concentrations) we measured a 0-2 log reduction in bacterial viability of P. aeruginosa, S. aureus or a polymicrobial biofilm. Conversely, addition of gentamicin loaded calcium sulfate beads resulted in 5-9 log reductions in P. aeruginosa, S aureus and polymicrobial biofilms derived from three subjects. We conclude that systemically administered antibiotics are likely to be inadequate for successfully treating these infections, especially given the vastly increased concentrations required to inhibit cells in a biofilm, and that topical antibiotics provide a more effective alternative.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.