| 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