1. Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge
- Author
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Maurer, Steven M, Hepp, Zehra S, McCallin, Shawna, Waibel, Felix W A, Romero, Federico C, Zorman, Yılmaz, Lipsky, Benjamin A, Uçkay, İlker, University of Zurich, and Uçkay, İlker
- Subjects
2732 Orthopedics and Sports Medicine ,Infectious Diseases ,610 Medicine & health ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,Orthopedics and Sports Medicine ,Surgery ,2725 Infectious Diseases ,2746 Surgery - 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.
- Published
- 2022