The use of gentamycin-impregnated foam in the management of diabetic foot infections: a promising delivery system?

Diabetic foot ulcers are frequently complicated by infection due to increased bacterial load. Antimicrobial therapy is an important component of the management of these wounds; however, to be effective, the therapy must provide adequate tissue concentration of an appropriate antimicrobial agent at the target site. Thus, drug concentrations in the interstitial space are an important determinant of successful therapy. Gentamicin sulfate has been proven to be active in vitro against many strains of Gram-negative and Gram-positive pathogens, yet it is often overlooked as a treatment option owing to toxicity risks associated with parenteral delivery. The incorporation of this agent into a collagen-gentamicin implant allows physicians to limit risk by providing a controlled dose of the drug to the target site. This decreased level of risk, combined with the fact that the implant is biocompatible and does not require removal, makes the gentamicin-collagen implant a superior drug delivery system.