European Journal of Biomedical and Pharmaceutical Sciences

RESISTANCE-FREE THERAPEUTIC EFFICACY AND SAFETY PROFILE OF JUC LONG-ACTING ANTIBACTERIAL MATERIAL IN DIABETES-RELATED SKIN AND MUCOSAL LESIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS

You Liang Cai, Jeannie, Dong Ling Qiu, Tjing Yung Loo*

ABSTRACT

Objective: To systematically evaluate the clinical efficacy, safety, and unique advantages of JUC long-acting antibacterial material in the management of diabetes-related skin and mucosal lesions (diabetic foot ulcers, surgical wounds, perineal incisions, etc.) among high-risk diabetic subgroups, with a focus on tailored application protocols. Methods: Relevant clinical studies on JUC for diabetes-related lesions published up to January 2026 were retrieved from CNKI, PubMed, Web of Science, and Wanfang Data. After literature screening, data extraction, and quality assessment using the Cochrane Risk of Bias Tool 2.0 (for randomized controlled trials [RCTs]) and Newcastle-Ottawa Scale (for non-RCTs), meta-analysis was performed using RevMan 5.4 software. Core outcome indicators included total effective rate, healing time, infection rate, local induration rate, adverse reaction rate, and drug resistance rate—analyzed for both the overall diabetic population and high-risk subgroups (end-stage nephropathy, severe peripheral neuropathy, Wagner grade ≥3 diabetic foot ulcers [DFU], gestational diabetes). Results: A total of 28 eligible studies (n=2,364 diabetic patients) were included, comprising 15 RCTs and 13 non-RCTs. Meta-analysis showed that compared with conventional treatments, JUC significantly improved the total effective rate in diabetic patients (RR=1.35, 95% CI [1.28, 1.43], p<0.00001), shortened healing time by 8.36 days (MD=-8.36, 95% CI [-10.12, -6.60], p<0.00001), reduced infection rate (RR=0.22, 95% CI [0.15, 0.32], p<0.00001), and lowered local induration rate (RR=0.29, 95% CI [0.13, 0.65], p=0.003). The overall adverse reaction rate of JUC in diabetic patients was 3.1% (95% CI [1.8%, 4.4%]), mainly mild skin dryness and local redness, with no severe adverse events. Notably, JUC had a 0% drug resistance rate against common pathogens (including MRSA and multidrug-resistant Klebsiella pneumoniae) isolated from diabetic lesions, compared to 23.5%–97.8% drug resistance with conventional antibiotics. High-risk subgroups benefited from tailored dosage and application adjustments: end-stage nephropathy patients (eGFR <30 mL/min/1.73m²) had a 2.8% adverse reaction rate with reduced frequency (2 times/day) and volume (0.5–1 mL); severe neuropathy patients maintained efficacy with visual monitoring and non-adherent dressings; Wagner grade ≥3 DFU patients achieved a 91.2% total effective rate with layered, edge-first spraying; and gestational diabetes patients had a 97.8% perineal incision healing rate with targeted, low-volume application. Conclusion: JUC exhibits significant efficacy and excellent safety in diabetic patients with skin and mucosal lesions, with unique advantages including physical antibacterial action (0% resistance), dual wound healing promotion, and adaptability to high-risk subgroups. Tailored application protocols further minimize side effects, making JUC a critical clinical alternative to antibiotic-based therapies for diabetic populations with impaired wound healing and high infection risk.

Keywords: JUC; Jieyoushen; diabetes mellitus; diabetic foot ulcer; diabetes-related skin lesions; antibacterial material; meta-analysis; drug resistance; wound healing; high-risk subgroups.