Antimicrobial therapy in infectious complications of diabetic foot

• Main Authors: Marin Ioan, Zaharia Roxana, Lupu Leonard, Rusu Emilia, Radulian Gabriela
• Format: Article
• Language: English
• Published: Sciendo 2014-03-01
• Series: Romanian Journal of Diabetes Nutrition and Metabolic Diseases
• Subjects: diabetic foot; antimicrobial therapy; amputations
• Online Access: http://www.degruyter.com/view/j/rjdnmd.2014.21.issue-1/rjdnmd-2014-0009/rjdnmd-2014-0009.xml?format=INT

Background and aims: The treatment of diabetic foot complications is combined, surgical and medical. The aim of our study was to assess the results of antimicrobial therapy in diabetic foot infections. Material and methods: 100 patients with diabetic foot infections admitted in the Surgery Clinic “I. Juvara” between December 2010 and February 2011 were analyzed. Results: Mean age at presentation was 58.4±9.74 years for women and 63.2±10.53 years for men. Mean diabetes duration was 12.3 years in men and 15.7 years in women. Patients with peripheral arterial disease represented 45% of cases, patients with neuropathy represented 16% of cases and patients with both conditions 39% of the cases. 41 patients suffered minor surgical interventions, 36 patients experienced minor amputations and 23 major amputations (below or above the knee). Antibiotic treatment included cephalosporins, fluoroquinolones and combinations with Metronidazole. After treatment, 74% of patients had a good postoperative evolution. For 26 patients a change of the antibiotic was necessary but only in 10 cases this was made according to antibiogram. Conclusions: Surgical debridement and wound management, carefully chosen antimicrobial therapy and treatment of comorbidities are very important for a successful outcome. Initial empirical antibiotic selection should be followed by culture-guided definitive therapy.