Karim Gariani1,2, Dan Lebowitz1,3, Benjamin Kressmann1, Elodie von Dach1, Parham Sendi4,5, Felix Waibel6, Martin Berli6, Tanja Huber7, Benjamin A Lipsky1,8, Ilker Uçkay1,9. 1. Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland. 2. Service of Diabetology and Endocrinology, Geneva University Hospitals, Geneva, Switzerland. 3. Service of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland. 4. Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland. 5. Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland. 6. Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland. 7. Pharmacology, Balgrist University Hospital, Zurich, Switzerland. 8. Department of Medicine, University of Washington, Seattle, WA. 9. Infectiology, Balgrist University Hospital, Zurich, Switzerland.
Abstract
AIM: To assess amoxicillin-clavulanate (AMC) for the oral therapy of diabetic foot infections (DFIs), especially for diabetic foot osteomyelitis (DFO). METHODS: We performed a retrospective cohort analysis among 794 DFI episodes, including 339 DFO cases. RESULTS: The median duration of antibiotic therapy after surgical debridement (including partial amputation) was 30 days (DFO, 30 days). Oral AMC was prescribed for a median of 20 days (interquartile range, 12-30 days). The median ratio of oral AMC among the entire antibiotic treatment was 0.9 (interquartile range, 0.7-1.0). After a median follow-up of 3.3 years, 178 DFIs (22%) overall recurred (DFO, 75; 22%). Overall, oral AMC led to 74% remission compared with 79% with other regimens (χ2 -test; P = 0.15). In multivariate analyses and stratified subgroup analyses, oral AMC resulted in similar clinical outcomes to other antimicrobial regimens, when used orally from the start, after an initial parenteral therapy, or when prescribed for DFO. CONCLUSIONS: Oral AMC is a reasonable option when treating patients with DFIs and DFOs.
AIM: To assess amoxicillin-clavulanate (AMC) for the oral therapy of diabetic foot infections (DFIs), especially for diabetic foot osteomyelitis (DFO). METHODS: We performed a retrospective cohort analysis among 794 DFI episodes, including 339 DFO cases. RESULTS: The median duration of antibiotic therapy after surgical debridement (including partial amputation) was 30 days (DFO, 30 days). Oral AMC was prescribed for a median of 20 days (interquartile range, 12-30 days). The median ratio of oral AMC among the entire antibiotic treatment was 0.9 (interquartile range, 0.7-1.0). After a median follow-up of 3.3 years, 178 DFIs (22%) overall recurred (DFO, 75; 22%). Overall, oral AMC led to 74% remission compared with 79% with other regimens (χ2 -test; P = 0.15). In multivariate analyses and stratified subgroup analyses, oral AMC resulted in similar clinical outcomes to other antimicrobial regimens, when used orally from the start, after an initial parenteral therapy, or when prescribed for DFO. CONCLUSIONS: Oral AMC is a reasonable option when treating patients with DFIs and DFOs.
Authors: Karim Gariani; Jean-Christophe Richard; Benjamin Kressmann; François R Jornayvaz; Jacques Philippe; Benjamin A Lipsky; Ilker Uçkay Journal: Ann Surg Date: 2021-09-15 Impact factor: 13.787
Authors: Ilker Uçkay; Dan Lebowitz; Benjamin Kressmann; Elodie von Dach; Benjamin A Lipsky; Karim Gariani Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2022-05-23
Authors: Ilker Uçkay; Dominique Holy; Madlaina Schöni; Felix W A Waibel; Tudor Trache; Jan Burkhard; Thomas Böni; Benjamin A Lipsky; Martin C Berli Journal: Endocrinol Diabetes Metab Date: 2021-02-09
Authors: Steven M Maurer; Zehra S Hepp; Shawna McCallin; Felix W A Waibel; Federico C Romero; Yılmaz Zorman; Benjamin A Lipsky; İlker Uçkay Journal: J Bone Jt Infect Date: 2022-03-25