[Antibiotic treatment for diabetic foot. Advantages of intravenous regional route as alternative for systemic route].
Diabetic angiopathy prevents adequate access of antibiotic agents to septic areas of the diabetic foot. We treated 22 such patients with antibiotics infused through a superficial vein associated to tourniquet occlusion of the limb (Group A). A control group of 47 patients, similar in age, sex and severity of diabetes received conventional systemic therapy (Group B). 45% of the patients exhibited occlusive arterial disease. Surgery was performed by the same team in both groups. Group A received regional anesthesia at the same time of the first antibiotic infusion. Group B received general or spinal anesthesia. Amputation was required in 5% of patients in Group A compared to 30% of patients in Group B (p < 0.02). Hospital stay was also significantly shorter in patients from Group A. No complications of this form of therapy were observed. Thus, regional antibiotic therapy may improve prognosis and facilitate management in patients with septic diabetic foot.
Acevedo
A
A
Servicio de Cirurgía, Hospital del Salvador, Santiago, Chile.
Schoop
W
W
Schnell
A
A
Toledo
L
L
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000145:classification / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications*; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007263:Infusions, Parenteral / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents
Tratamiento antibiótico del pie diabético. Ventajas de la vía regional intravenosa como alternativa a la vía sistémica.