Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Stengel, D; Görzer, E; Schintler, M; Legat, FJ; Amann, W; Pieber, T; Ekkernkamp, A; Graninger, W.
Second-line treatment of limb-threatening diabetic foot infections with intravenous fosfomycin.
J Chemother. 2005; 17(5):527-535
Doi: 10.1179/joc.2005.17.5.527
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Fließer-Görzer Evelyn
- Graninger Winfried
- Legat Franz
- Pieber Thomas
- Schintler Michael
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- Abstract:
- Diabetic foot infections (DFI) expanding to bones and joints are associated with a poor prognosis of limb salvage. The bactericidal epoxide fosfomycin accumulates in inflamed soft and bone tissue, and may represent a potential treatment option for targeting severe DFI. Fifty-two patients (35 men, 17 women, mean age 62.9 +/- SD 9.2 years) with limb-threatening DFI (that is, Wagner grade 3 and higher) were enrolled in a multi-center compassionate use program of fosfomycin. Twenty-two patients (42.4%) had unsuccessfully been pretreated with other antimicrobials. Besides standard treatment (topical wound care and surgical debridement), eligible subjects received a combination of 8 to 24 g fosfomycin daily, and a conventional antibiotic agent, usually a beta-lactam compound. Treatment duration averaged 14.4 +/- 8.3 days. Limb-sparing surgery was possible in 48 patients (92.3%, 95% confidence interval 81.5-97.9%). Only four participants faced mild drug-related side effects (nausea, rash). Logistic regression analysis showed a trend towards better results with prolonged treatment, whereas a dose increase above 12 g daily did not affect outcomes. In DFI being resistant to conventional antibiotic agents, intravenous fosfomycin offers an effective treatment choice that may increase the likelihood of limb preservation. The present data warrant a larger comparative trial to stabilize effect estimates.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Anti-Bacterial Agents - therapeutic use
- Bacterial Infections - drug therapy
- Bacterial Infections - etiology
- Debridement -
- Diabetic Foot - drug therapy
- Diabetic Foot - microbiology
- Female -
- Fosfomycin - therapeutic use
- Humans -
- Infusions, Intravenous -
- Male -
- Middle Aged -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- diabetic foot
- fosfomycin
- osteomyelitis
- amputation