Use of antibiotic-PMMA beads in the ischemic foot.

Thirty-six patients with 44 ischemic foot infections were managed with antibiotic-polymethylmethacrylate (PMMA) beads. Most of these patients received gentamicin-impregnated PMMA beads but tobramycin and vancomycin-impregnated PMMA beads were used on three patients. Angiopathy occurred in 35 patients secondary to diabetes and secondary to renal disease in 2; 1 patient had both diabetes and renal disease. The most common bacteria was Staphylococcus aureus (82%), although other organisms and multiple bacteria were present. In spite of the variability of the bacteria, PMMA beads were helpful in managing foot infections in this difficult patient population.