Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge.

IF 1.8 Q3 INFECTIOUS DISEASES Journal of Bone and Joint Infection Pub Date : 2022-01-01 DOI:10.5194/jbji-7-61-2022
Steven M Maurer, Zehra S Hepp, Shawna McCallin, Felix W A Waibel, Federico C Romero, Yılmaz Zorman, Benjamin A Lipsky, İlker Uçkay
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引用次数: 6

Abstract

Diabetic foot infection is a frequent complication in long-standing diabetes mellitus. For antimicrobial therapy of this infection, both the optimal duration and the route of administration are often based more on expert opinion than on published evidence. We reviewed the scientific literature, specifically seeking prospective trials, and aimed at addressing two clinical issues: (1) shortening the currently recommended antibiotic duration and (2) using oral (rather than parenteral) therapy, especially after the patient has undergone debridement and revascularization. We also reviewed some older key articles that are critical to our understanding of the treatment of these infections, particularly with respect to diabetic foot osteomyelitis. Our conclusion is that the maximum duration of antibiotic therapy for osteomyelitis should be no more than to 4-6 weeks and might even be shorter in selected cases. In the future, in addition to conducting randomized trials and propagating national and international guidance, we should also explore innovative strategies, such as intraosseous antibiotic agents and bacteriophages.

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短期和口服抗菌药物治疗糖尿病足感染:当前知识的叙述回顾。
糖尿病足感染是长期糖尿病患者的常见并发症。对于这种感染的抗菌治疗,最佳持续时间和给药途径往往更多地基于专家意见,而不是公开的证据。我们回顾了科学文献,特别寻找前瞻性试验,旨在解决两个临床问题:(1)缩短目前推荐的抗生素持续时间;(2)使用口服(而不是肠外)治疗,特别是在患者进行清创和血供重建术后。我们也回顾了一些旧的关键文章,这些文章对我们理解这些感染的治疗至关重要,特别是关于糖尿病足骨髓炎。我们的结论是,抗生素治疗骨髓炎的最长持续时间不应超过4-6周,在某些情况下甚至可以更短。未来,除了开展随机试验和宣传国家和国际指导外,我们还应该探索创新策略,如骨内抗生素和噬菌体。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
29
审稿时长
12 weeks
期刊最新文献
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