CRD Summary: From the limited evidence available, MRSA isolation seemed to be a significant factor for treatment failure in patients with diabetic foot infections, but further research was required. Given several limitations with the evidence available, including apparently low quality and clinical and methodological heterogeneity, the authors’ cautious conclusions and recommendations for further research appear appropriate.

CRD Commentary: The objectives of the review and supporting inclusion criteria were clearly stated. The literature search was limited to two electronic databases and one further appropriate source. Although no attempts to minimise publication or language bias were reported, tests showed no evidence of publication bias. The study selection and data extraction processes were made explicit, thus minimising the risk for reviewer error and bias. The authors stated that most studies were of low quality, but criteria used to assess studies were not reported, so it was not possible to verify the authors' findings. Although the authors reported that there was no statistically significant heterogeneity among studies, they acknowledged clinical and methodological differences. Given the limited evidence available, and the above-mentioned considerations, the authors’ cautious conclusions and recommendations for further research appear appropriate.