Summary:In patients with diabetic foot osteomyelitis (DFO), oral N-acetyl-cysteine (NAC) 600 mg twice daily as an adjuvant therapy significantly accelerated antibiotic responses and reduced infectious inflammatory markers during therapy compared to standard therapy without NAC, though it was associated with minimal side effects.
Source: Laya Hooshmand Gharabagh, et al. “Efficacy Of N-Acetyl-Cysteine as Adjuvant Therapy for Diabetic Foot Osteomyelitis: An Open-Label Randomized Controlled Trial.” Read article here.
| PICO | Description |
|---|---|
| Population | Patients diagnosed with diabetic foot osteomyelitis (DFO). |
| Intervention | Oral N-acetyl-cysteine (NAC) 600 mg administered twice daily as an adjuvant to standard therapy. |
| Comparison | Standard therapy without the addition of NAC. |
| Outcome | NAC significantly accelerated antibiotic responses and reduced infectious inflammatory markers during treatment with minimal side effects. The overall trend showed faster improvement in DFO-related infection markers. |
RCT
Arch Iran Med · 2025
NAC adjuvant for diabetic foot osteomyelitis
Open-label RCT · diabetic foot osteomyelitis · 3 weeks
Trial design
Change from baseline — both arms
ESR drop (NAC)
-49.4 mm/h
vs -7.2 control
CRP drop (NAC)
-44.4 mg/L
vs -14.0 control
Completed
53 patients
grade III/IV
Tolerability
Minimal AEs
well tolerated
⬡ Bottom Line
Adding oral NAC 600 mg twice daily accelerated the fall in ESR and CRP versus standard antibiotic therapy alone in diabetic foot osteomyelitis, with minimal side effects.
P
Population
Patients with diabetic foot osteomyelitis (Wagner grade III/IV)
I
Intervention
Oral N-acetyl-cysteine 600 mg twice daily as adjuvant therapy
C
Comparator
Standard antibiotic therapy without NAC
O
Outcome
Accelerated reduction in ESR and CRP during treatment
