Preoperative Antibiotic Administration Does Not Improve the Outcomes of Operated Diabetic Foot Infections.

IF 4.3 2区 医学 Q1 INFECTIOUS DISEASES
Thaddaeus Muri, Madlaina Schöni, Felix W A Waibel, Dominique Altmann, Christina Sydler, Pascal R Furrer, Francesca Napoli, İlker Uçkay
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Abstract

Many patients with community-acquired diabetic foot infections (DFI) receive systemic (empirical) antibiotic treatments before surgical interventions, often by the general practitioner. Sometimes, hospital clinicians prescribe them before surgery to reduce the infection inoculum and preserve soft tissue for immediate wound closure in case of residual infection after surgery. In contrast, the international guidelines (IWGDF) advocate against presurgical antibiotic use in routine situations without severe progredient soft tissue infections and/or sepsis. We run several retrospective and prospective cohorts of DFI and retrospectively analyze the influence of presurgical antibiotic therapy (as binary (yes/no) or continuous (in days) variables) on failures after a combined surgical and medical treatment. In our large database, the presence, choice, administration routes, or duration of preoperative antibiotic therapy did not improve the postoperative outcomes of operated diabetic foot infections or prevent their failures. In turn, this lack of influence leaves space for enhanced antibiotic stewardship in the management of DFI.

术前给药抗生素不能改善手术后糖尿病足感染的预后。
许多社区获得性糖尿病足感染(DFI)的患者在手术干预前通常由全科医生进行全身(经验性)抗生素治疗。有时,医院临床医生在手术前开处方,以减少感染接种,并保存软组织,以便在术后残留感染的情况下立即关闭伤口。相比之下,国际指南(IWGDF)提倡在没有严重进行性软组织感染和/或败血症的常规情况下,不要在手术前使用抗生素。我们对DFI进行了几个回顾性和前瞻性队列研究,并回顾性分析了手术前抗生素治疗(作为二元(是/否)或连续(以天为单位)变量)对手术和药物联合治疗后失败的影响。在我们的大型数据库中,术前抗生素治疗的存在、选择、给药途径或持续时间并没有改善手术后糖尿病足感染的预后或预防其失败。反过来,这种影响力的缺乏为加强DFI管理中的抗生素管理留下了空间。
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来源期刊
Antibiotics-Basel
Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics
CiteScore
7.30
自引率
14.60%
发文量
1547
审稿时长
11 weeks
期刊介绍: Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.
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