在糖尿病患者足感染中的实证抗生素治疗增加了住院治疗
Brian M Schmidt1, Keith S Kaye2, David G Armstrong3
1Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health, Ann Arbor, Michigan, USA.
Open forum infectious diseases
|October 18, 2023
概括
与经验治疗相比,用于感染糖尿病足 (DFU) 的培养导向抗生素可以减少住院治疗. 建议在所有严重程度的DFU感染中采集组织培养,以改善患者的治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 糖尿病学 糖尿病学
- 足部医学是一门专业.
背景情况:
- 糖尿病足 (DFU) 是糖尿病的一个重要并发症.
- 受感染的DFU需要迅速和有效的抗生素管理.
- 门诊多学科中心管理大量的DFU病例.
研究的目的:
- 评估感染的DFU初始抗生素管理策略的结果.
- 根据抗生素选择,比较住院率,截肢率和死亡率.
- 为了确定培养导向或经验性抗生素治疗是否对感染的DFU优越.
主要方法:
- 分析了116名感染DFU的门诊患者的队列.
- 根据IDSA标准,感染按严重程度分层 (轻度,中度,严重).
- 结果 (住院治疗,截肢,死亡) 被追踪了抗生素开始后的一年.
主要成果:
- 在39名患者中使用经验性抗生素;在77名患者中使用培养指导.
- 接受经验性抗生素治疗轻度感染的患者住院的风险高出1.87倍.
- 两组之间没有观察到截肢或死亡率的显著差异.
结论:
- 对于受感染的DFU,建议进行培养引导的抗生素治疗,无论严重程度如何.
- 使用组织培养来指导抗生素选择可以减少DFU相关的住院治疗.
- 优化抗生素选择对于管理感染糖尿病足至关重要.
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