Three versus six weeks of post-amputation antibiotic therapy in diabetic forefoot osteomyelitis with positive culture for residual infected bone

IF 2.9 4区医学 Q2 INFECTIOUS DISEASES Infectious diseases now Pub Date : 2024-09-06 DOI:10.1016/j.idnow.2024.104975

Maïwenn Petithomme-Nanrocki , Ines Slitine , Saidou Diallo , Martine Crouzet , Malorie Mostaert , Pascale Moysset , Thanh Quang Sang Ly , Maxime Hentzien , Maud Francois , Firouzé Bani-Sadr

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Abstract

Objectives

In 2021 in our university hospital, it was decided in a multidisciplinary consultation meeting on osteoarticular infection in patients with diabetic foot to reduce the duration of post-amputation antibiotic therapy from six to three weeks in patients with diabetic forefoot osteomyelitis and residual bone infection. This study aimed to compare clinical outcomes in this group of patients, before vs after the change in practice introduced in 2021.

Methods

In this before-after study, we included all cases reported between January 2016 and August 2023 in the University Hospital of Reims.

Results

We included 113 patients; between 2016 and 2020, 56 (49.5 %) received six weeks of post-amputation antibiotic therapy, and between 2021 and 2023, 57 (50.5 %) received three weeks of therapy. Over six months of follow-up, overall cure rate was 95 %. Treatment failure did not differ between groups.

Conclusion

Three weeks of post-amputation antibiotic therapy in diabetic patients with forefoot osteomyelitis and residual bone infection is effective.

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糖尿病前足骨髓炎患者截肢后抗生素治疗三周与六周，残留感染骨培养阳性的比较

目的：2021 年，我们大学医院在糖尿病足患者骨关节感染多学科咨询会议上决定，将糖尿病前足骨髓炎和残留骨感染患者截肢后抗生素治疗时间从 6 周缩短至 3 周。本研究旨在比较这组患者在2021年实行这一做法前后的临床疗效：在这项前后对比研究中，我们纳入了兰斯大学医院在2016年1月至2023年8月期间报告的所有病例：我们共纳入了 113 例患者；2016 年至 2020 年间，56 例（49.5%）患者接受了为期六周的截肢后抗生素治疗；2021 年至 2023 年间，57 例（50.5%）患者接受了为期三周的治疗。在6个月的随访中，总体治愈率为95%。各组间治疗失败率无差异：结论：对患有前足骨髓炎和残留骨感染的糖尿病患者，截肢后三周的抗生素治疗是有效的。

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