Efficacy of Huangbai liniment for diabetic foot ulcers with multidrug-resistant organism infection: a randomized controlled multicenter trial
- 1Department of Peripheral Vascular, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China
- 2Xiyuan Hospital of China Academy of Chinese Medical Sciences, Postdoctoral Research Station of China Academy of Chinese Medical Sciences, Beijing, China
Abstract
Background: Diabetic foot infection, particularly with multidrug-resistant organisms (MDROs), is a serious complication of diabetic foot ulcers (DFUs) that increases wound healing time and amputation risk. Prolonged use of broad-spectrum antibiotics can contribute to antibiotic resistance and limit future treatment options. Developing effective non-antibiotic antibacterial therapies is therefore urgently needed. Huangbai liniment (HB) is a standardized herbal product clinically used to treat diabetic foot infections, including methicillin-resistant Staphylococcus aureusStaphylococcus aureus (MRSA). This trial assessed the efficacy and safety of HB for DFUs with mild MDRO infection.
Methods: This multicenter, open-label, randomized controlled trial was conducted in China. A total of 154 patients with DFUs and mild MDRO infection were randomly assigned to the HB group and the silver dressing (SD) group. Both groups received the same basic treatment for diabetic foot disease. The HB group received Tazi therapy (topical application of HB) for 2 weeks, while the control group was treated with SD. Primary outcome was the resolution of infection defined as a change from mild infection to no infection (using the Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections). Secondary outcomes included the MDRO conversion rate, rate of completing ulcer healing, and reduction in ulcer size.
Results: A total of 74 patients in the HB group and 63 patients in the SD group were included. Infection was resolved in 35 patients (47.3%) in the HB group versus 13 patients (20.6%) in the SD group (p = 0.001). Mixed-level logistic regression analyses showed that the HB group was associated with resolution of infection [odds ratio (OR) = 4.81; 95% confidence interval (CI): 2.01–12.48; p < 0.001]. However, there was no difference in rate of completing ulcer healing and reduction of ulcer size.
Conclusion: Topical HB effectively facilitated mild infection resolution and MDRO conversion, with no adverse effects. HB is an effective and safe adjunctive therapy for short-term infection resolution in patients with DFU with mild MDRO infection. However, no evidence emerged for improved ulcer healing within 2 weeks. Longer follow-up is needed to assess wound healing outcomes.
Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=66175., identifier ChiCTR2000041443.
Related
- Early sputum bacterial load dynamics predict treatment response in multidrug-resistant/rifampicin-resistant tuberculosis: A multicenter prospective cohort study
- A High-Energy Military Femoral Fracture With Multidrug-Resistant Infection: A Case Report.
- Case Report: Herbal nutritional intervention in a critically ill ALS patient with multidrug-resistant infection.
- Fronto-temporal transcranial direct current stimulation reduces symptoms in treatment-resistant schizophrenia: a randomized sham-controlled trial
- Efficacy and safety of Anas barbariae 200K in influenza-like illness: a randomized double-blind, placebo-controlled, multicenter study
BibTeX
@article{wang2026efficacy,
title = {{Efficacy of Huangbai liniment for diabetic foot ulcers with multidrug-resistant organism infection: a randomized controlled multicenter trial}},
author = {Ning Wang and Gang Wang and Min Zhou and Keren Zhang and Tong Zhou and Xuewan Wang and Guangyao Yang and Lijuan Deng and Tianyi Huang and Shang Ju},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1926211},
url = {https://doi.org/10.3389/fendo.2026.1926211},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Efficacy of Huangbai liniment for diabetic foot ulcers with multidrug-resistant organism infection: a randomized controlled multicenter trial
AU - Ning Wang
AU - Gang Wang
AU - Min Zhou
AU - Keren Zhang
AU - Tong Zhou
AU - Xuewan Wang
AU - Guangyao Yang
AU - Lijuan Deng
AU - Tianyi Huang
AU - Shang Ju
PY - 2026
DA - 2026/10/12
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1926211
UR - https://doi.org/10.3389/fendo.2026.1926211
AB - Background: Diabetic foot infection, particularly with multidrug-resistant organisms (MDROs), is a serious complication of diabetic foot ulcers (DFUs) that increases wound healing time and amputation risk. Prolonged use of broad-spectrum antibiotics can contribute to antibiotic resistance and limit future treatment options. Developing effective non-antibiotic antibacterial therapies is therefore urgently needed. Huangbai liniment (HB) is a standardized herbal product clinically used to treat diabetic foot infections, including methicillin-resistant Staphylococcus aureusStaphylococcus aureus (MRSA). This trial assessed the efficacy and safety of HB for DFUs with mild MDRO infection. Methods: This multicenter, open-label, randomized controlled trial was conducted in China. A total of 154 patients with DFUs and mild MDRO infection were randomly assigned to the HB group and the silver dressing (SD) group. Both groups received the same basic treatment for diabetic foot disease. The HB group received Tazi therapy (topical application of HB) for 2 weeks, while the control group was treated with SD. Primary outcome was the resolution of infection defined as a change from mild infection to no infection (using the Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections). Secondary outcomes included the MDRO conversion rate, rate of completing ulcer healing, and reduction in ulcer size. Results: A total of 74 patients in the HB group and 63 patients in the SD group were included. Infection was resolved in 35 patients (47.3%) in the HB group versus 13 patients (20.6%) in the SD group (p = 0.001). Mixed-level logistic regression analyses showed that the HB group was associated with resolution of infection [odds ratio (OR) = 4.81; 95% confidence interval (CI): 2.01–12.48; p < 0.001]. However, there was no difference in rate of completing ulcer healing and reduction of ulcer size. Conclusion: Topical HB effectively facilitated mild infection resolution and MDRO conversion, with no adverse effects. HB is an effective and safe adjunctive therapy for short-term infection resolution in patients with DFU with mild MDRO infection. However, no evidence emerged for improved ulcer healing within 2 weeks. Longer follow-up is needed to assess wound healing outcomes. Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=66175., identifier ChiCTR2000041443.
SN - 1664-2392
ER -