title: Bacterial flora in mal perforant and antimicrobial treatment with ceftriaxone.
abstract: The objectives of this pilot study were to identify the bacterial flora of neurotrophic ulcers, and to determine whether treatment with ceftriaxone improves the clinical picture. Twenty-five patients (15 male, 10 female, mean age 70 +/- 11 years) with mal perforant were treated with 2 g ceftriaxone once daily until the ulcer was healed, or for a period of 6 weeks. Biopsies were taken from the ulcer floor before and after therapy. Initially, the following bacteria were found, in order of frequency: Staphylococcus aureus, enterobacteria, coagulase-negative staphylococci, enterococci and streptococci as well as Pseudomonas aeruginosa. Under therapy with ceftriaxone, the lesions of 11 patients were healed; in 5 patients improvement > 50% was observed and in 4 patients improvement was < 50%. In 3 patients there was no change in the condition. Two patients had to stop treatment due to diarrhea. Asepsis was achieved in 5 patients despite persistence of the ulcer. The control group (25 patients without antibiotic therapy) showed the following results: healing in 6, improvement > 50% in 5, improvement < 50% in 10, and no change in 4. The results for the treatment group have to be compared with a historical control group since, for ethical reasons, the implementation of a double-blind study would not be feasible.
authors: Vascular Outpatient Clinic, Hanusch Hospital, Vienna, Austria.
authors: M
authors: M
authors: Hirschl
authors: A M
authors: AM
authors: Hirschl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification*; D002443:Ceftriaxone / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D016523:Foot Ulcer / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D010865:Pilot Projects
chemical_list: D002443:Ceftriaxone