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Use of antibiotic-PMMA beads in the ischemic foot
J H Calhoun1, K Klemm, D M Anger
1Div of Orthopedic Surgery, University of Texas Medical Branch, Galveston 77555-0792.
Abstract:
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.
Insights
Antibiotic-polymethylmethacrylate (PMMA) beads effectively managed ischemic foot infections in 36 patients. This treatment approach showed success even with varied bacterial infections, including Staphylococcus aureus, in a challenging patient group.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Diabetic Foot Care
Background:
- Ischemic foot infections pose significant challenges in patients with diabetes and renal disease.
- Staphylococcus aureus is a predominant pathogen in these infections.
- Polymethylmethacrylate (PMMA) beads offer a localized antibiotic delivery system.
Purpose of the Study:
- To evaluate the efficacy of antibiotic-polymethylmethacrylate (PMMA) beads in managing ischemic foot infections.
- To assess the outcomes in a patient population with comorbidities like diabetes and renal disease.
- To identify common bacterial pathogens and their susceptibility to antibiotic-PMMA bead treatment.
Main Methods:
- A retrospective review of 36 patients with 44 ischemic foot infections treated with antibiotic-PMMA beads.
- Gentamicin-impregnated PMMA beads were most commonly used; tobramycin and vancomycin were used in a few cases.
- Patient data included underlying conditions (diabetes, renal disease) and bacterial cultures.
Main Results:
- Antibiotic-PMMA beads were found to be helpful in managing these difficult foot infections.
- Staphylococcus aureus was the most common bacteria isolated (82%).
- The treatment was effective despite the presence of other organisms and polymicrobial infections.
Conclusions:
- Antibiotic-PMMA beads represent a valuable therapeutic option for ischemic foot infections, particularly in patients with diabetes and renal disease.
- Localized antibiotic delivery via PMMA beads can be effective against a range of bacterial pathogens.
- Further research may explore optimal antibiotic choices and treatment durations for varied infections.