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Antibiotic combinations in polymicrobic diabetic foot infections
1All India Institute of Diabetes, S.L. Raheja Hospital, Mahim, Mumbai-400 016.
Indian Journal of Medical Sciences
|May 25, 2002
Summary
This study evaluated antibiotic combinations for diabetic foot infections. Amikacin/Piperacillin, Ampicillin-Sulbactum/Piperacillin, Ampicillin-Sulbactum/Cefoperazone, and Ofloxacillin/Cefotaxime showed significant synergistic potential.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Diabetic foot infections are a significant clinical challenge.
- Multidrug-resistant pathogens complicate treatment.
- Evaluating synergistic antibiotic combinations is crucial for effective management.
Purpose of the Study:
- To assess the synergistic potential of various antibiotic combinations against pathogens from diabetic foot wounds.
- To identify effective antibiotic pairings for treating these infections.
Main Methods:
- Prospective study of 272 diabetic foot patients over two years.
- Microbiological analysis of tissue curettage samples to isolate aerobic and anaerobic pathogens.
- Antibiotic susceptibility testing and microtitre checkerboard assay to determine synergy.
Main Results:
- Synergy was observed in 21.74% to 59.57% of tested combinations.
- Four combinations demonstrated significant clinical potential: Amikacin/Piperacillin (77.50%), Ampicillin-Sulbactum/Piperacillin (76.92%), Ampicillin-Sulbactum/Cefoperazone (74.47%), and Ofloxacillin/Cefotaxime (71.43%).
Conclusions:
- Amikacin/Piperacillin exhibits proven synergistic potential.
- Ampicillin-Sulbactum in combination with Piperacillin or Cefoperazone is highly efficacious.
- Ofloxacillin/Cefotaxime also shows considerable promise.
- Synergistic antibiotic combinations are vital for managing diabetic foot infections effectively.