Efficacy of Sulbactam-Ampicillin for the Treatment of Severe Diabetic Foot Infections

Akova, Murat; Özcebe, Osman; Güllü, İbrahi̇m; Ünal, Sabri; Gür, Deniz; Akalın, Şerife; Tokgözoğlu, Mazhar; Telatar, Funda; Akalın, Halis

doi:10.1179/joc.1996.8.4.284

Cited by 35 publications

(10 citation statements)

References 13 publications

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“…Intravenous antibiotic therapy of ampicillin sulbactam has been shown to be safe and effective in the treatment of diabetic foot infections (11) and our hospitalized patients received the empirical therapy of ampicillin sulbactam, 4 g per day for at least 7 days prior to undergoing any type of diabetic foot surgery.…”

Section: Methodsmentioning

confidence: 99%

Preoperative medical treatment in patients undergoing diabetic foot surgery with a Wagner Grade-3 or higher ulcer: a retrospective analysis of 52 patients

Korkmaz

Erdoğan

BALCI

et al. 2012

Diabetic Foot & Ankle

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Diabetic foot ulcers (DFU) are one of the most important complications in people with diabetes mellitus. The present study was aimed to retrospectively review the efficacy of at least 1-week medical treatment before any surgical intervention in patients with Grade-3 and higher DFU according to Wagner's classification. A total of 52 patients (36 males and 16 females) hospitalized and treated between June 2006 and February 2009 and had initially received therapeutic treatment (local wound care, antibiotic therapy and blood glucose regulation) for a period of at least 1 week were included in the study. The level of amputation, rates of reulceration and mortality in both groups were recorded in the following period of 2 years. Group 1 (did not respond to preoperative medical intervention) included 16 patients where a surgical debridement, flap or skin graft surgery was performed in 2 (12.5%) patients, major amputation was performed in another 2 (12.5%) patients and minor amputation was performed in the remaining 12 (75%) patients. Of 36 patients in Group 2 (did respond to preoperative medical intervention), 5 (13.9%) patients underwent the surgical debridement, flap or skin graft surgery, 8 (22.2%) patients had a major amputation and the remaining 23 (63.9%) patients lead to a minor amputation. The ulcer recurrence and mortality rates were obtained as 2 (12.5%) and 2 (12.5%) in Group 1 and 2 (5.6%) and 1 (2.8%) in Group 2, respectively. Despite the lower rates of ulcer recurrence and mortality in patients having adequate responses to initial treatment before surgical procedures were performed, no statistically significant difference was observed between the 2 groups. In addition, there was no statistically significant difference between the levels of amputation in both groups.

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Section: Methodsmentioning

confidence: 99%

Preoperative medical treatment in patients undergoing diabetic foot surgery with a Wagner Grade-3 or higher ulcer: a retrospective analysis of 52 patients

Korkmaz

Erdoğan

BALCI

et al. 2012

Diabetic Foot & Ankle

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“…Agents that have demonstrated clinical effectiveness, alone or in combination, in prospective studies including entirely or mostly patients with diabetic foot infections, include the following [51]: cephalosporins (cephalexin orally; cefoxitin and ceftizoxime parenterally) [10,[52][53][54][55][56]; penicillin/b-lactamase inhibitor congeners (amoxicillin/clavulanate orally; ampicillin/ sulbactam, piperacillin/tazobactam, and ticarcillin/clavulanate parenterally) [57][58][59][60][61]; fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin, and trovafloxacin orally and parenterally) [57,[61][62][63][64][65]; and the miscellaneous agents clindamycin (orally and parenterally) [10,63,65], imipenem/cilastatin (parenterally) [58,66], amdinocillin (parenterally) [55], linezolid (orally and parenterally) [67], and pexiganan acetate (topically) [50].…”

Section: Antibiotic Therapymentioning

confidence: 99%

Medical Treatment of Diabetic Foot Infections

Lipsky

2004

Clinical Infectious Diseases

144

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Diabetic foot infections frequently cause morbidity, hospitalization, and amputations. Gram-positive cocci, especially staphylococci and also streptococci, are the predominant pathogens. Chronic or previously treated wounds often yield several microbes on culture, including gram-negative bacilli and anaerobes. Optimal culture specimens are wound tissue taken after debridement. Infection of a wound is defined clinically by the presence of purulent discharge or inflammation; systemic signs and symptoms are often lacking. Only infected wounds require antibiotic therapy, and the agents, route, and duration are predicated on the severity of infection. Mild to moderate infections can usually be treated in the outpatient setting with oral agents; severe infections require hospitalization and parenteral therapy. Empirical therapy must cover gram-positive cocci and should be broad spectrum for severe infections. Definitive therapy depends on culture results and the clinical response. Bone infection is particularly difficult to treat and often requires surgery. Several adjuvant agents may be beneficial in some cases.

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“…High rates of clinical cure using ampicillin-sulbactam have also been reported by Akova et al [32] in a study of 74 diabetic patients with severe foot infections, 25 of whom had soft-tissue infections and 49 of whom had osteomyelitis. After treatment for 14 days with parenteral ampicillin/sulbactam, 100% of patients with soft-tissue infections were cured.…”

Section: Diabetic Foot Infectionsmentioning

confidence: 64%

“…The ␤-lactam/␤-lactamase inhibitor combinations possess a good safety and tolerability profile and an antimicrobial spectrum that encompasses both aerobic and anaerobic organisms. Recent clinical studies have shown that these agents are appropriate for the initial empiric and definitive parenteral therapy of diabetic foot infections, and are well tolerated when given for long periods [31,32]. A comparative, double-blind trial was conducted in which 96 diabetic patients with limbthreatening foot infections were randomized to treatment with either ampicillin/sulbactam or imipenem/cilastatin [31].…”

Section: Diabetic Foot Infectionsmentioning

confidence: 99%

The Role ofβ-Lactam/β-Lactamase Inhibitor Combinations in Surgical Infections

Sayek

2001

Surgical Infections

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Many surgical infections are characterized by synergistic polymicrobial mixed infection, for which broad-spectrum antimicrobial therapy is usually administered on an empiric basis. Until relatively recently, standard empiric therapeutic regimens have involved the use of two or more antibiotics, such as aminoglycosides and anti-anaerobic agents, to achieve adequate aerobic and anaerobic coverage. There are often substantial drawbacks, however, such as drug-induced toxicity and high costs of treatment. Evidence from a number of clinical studies suggests that single-agent therapy with beta-lactam/beta-lactamase inhibitor combinations is a suitable and cost-effective alternative to multidrug regimens, as well as to monotherapy with cephalosporins or carbapenems in the treatment of intra-abdominal, gynecologic, and diabetic foot infections, and brain abscesses. These agents are also suitable for use in perioperative prophylaxis and may offer benefits over other agents in terms of reduced incidence of surgical wound infections and lower costs.

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Efficacy of Sulbactam-Ampicillin for the Treatment of Severe Diabetic Foot Infections

Cited by 35 publications

References 13 publications

Preoperative medical treatment in patients undergoing diabetic foot surgery with a Wagner Grade-3 or higher ulcer: a retrospective analysis of 52 patients

Preoperative medical treatment in patients undergoing diabetic foot surgery with a Wagner Grade-3 or higher ulcer: a retrospective analysis of 52 patients

Medical Treatment of Diabetic Foot Infections

The Role ofβ-Lactam/β-Lactamase Inhibitor Combinations in Surgical Infections

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