What Is the Best Option for Treating Venous Leg Ulcer Infection? Is It Systemic or Local Antimicrobials or a Combination of Both? A Retrospective Cohort Study

Abstract

Study aimed to find out best option (systemic or local antimicrobial or combination of both) for treating venous leg ulcer infection. Patients’ files were reviewed retrospectively. Participants were divided into three groups. First group was treated by systemic antibiotics only (SABG). Second group received local antibiotics only (LABG). Third group was treated by combination of both (SLABG). Treatment strategies were compared based on multiple parameters using Pearson chi-squared test & relative risk (RR). 456 participants identified: 153 in SABG, 152 in LABG and 151 in SLABG. It was found that SLABG group was statistically significantly better than other single treatment strategies regarding all parameters (except bacterial resistance): (i) ulcer healing within usual duration (10-14 days) was 2.4 time higher (RR 2.4, 95% CI: 1.84, 3.12), (ii) probability of not recurring ulcer was 2.6 time higher (iii) probability of not getting increased wound size, abscess,cellulites was 5 times higher (iv) probability of not developing septicemia was 40% higher (v) probability of not requiring surgical intervention was 30% higher (vi) fewer patients needed prolonged hospitalization & lower cost was 8 times more likely (vii) patients were 3 times more satisfied during treatment .Probability of bacterial resistance was six times higher with SLABG and 5 times higher with SABG compared to LABG. For RR & CI values for all above parameters, see results below Ultimately, combination of both systemic and local antimicrobials may be best option to treat venous leg ulcer infection with out- weight with emergence of antibiotic-resistance microorganism.

Fighting Against a sea of Troubles

“…In 2021, the journal has successfully published educational articles, 1,2 as well as articles on all aspects of wound management. 3,4 The present issue is also interesting. Anastasiou et al 5 discuss the evidence on the therapeutic properties of honey for diabetic foot ulcers.…”

Autumn Issue: Praise of Mighty Harmonies

“…Ersen et al 10 have examined prefabricated total contact cast kits in diabetic neuropathy. Abdulhamid et al 11 have compared systemic versus local antibiotics versus their combination for the management of infected venous leg ulcers. Ruznan et al 12 have evaluated the effects of stress on fabrics in compression bandaging.…”