Abstract
Examined and treated 1246 patients with complicated diabetic foot syndrome (DFS) for the period from 2010 to 2015 (326 patients - a comparison group, 888- main groups - representative) and of 32 patients in the Development of Sepsis. Found that in patients with pyonecrotic processes of DFS in which surgery is performed in an ambulatory, ABT can be administered in the tablet forms. Patients of groups II-III the one should remember that in the presence of sensitivity to multiple antimicrobials, use sequence - from the weaker to the stronger, and at the risk of MRSA – linezolid, daptomycin. With the development of sepsis - drugs of choice are fluoroquinolones of III - IV generation, carbapenems, and the presence of MRSA – linezolid, daptomycin or vancomycin. Suggested tactics of ABT contributed to the reduction of length of hospitalization, with an average of (31,4±1,8) to (19,4±2,3) patient days (t=3,32; P<0,05), and the reduction of postoperative mortality from 7,5 to 3,8% (x2=6,74; P<0,05).
Keywords: diabetic foot syndrome; sepsis; antibiotic therapy
References
- Beloborodov VA. “Treatment of purulent-necrotic complicated diabetic foot syndrome”. Modern medical technologies 3 (2013): 21-25
- SD Shapoval., et al. “Clinical classification of complicated diabetic foot syndrome”. Magazine named after N.I. Pirogov 6 (2011): 70-74.
- VV Boyko., et al. “Complex surgical treatment of diabetic foot syndrome”. Surgical perspective 1.8 (2014): 3-10.
- SD Shapoval., et al. “Surgical classification and treatment algorithm for complicated diabetic foot syndrome”. Methodological recommendations of the Ministry of Health of Ukraine. Kyiv (2012): 19.
- A Kumar., et al. “A survival benefit of combination antibiotic therapy for serious infections associated with sepsis and septic shock is contingent only on the risk of death: a meta-analytic/meta-regression study”. Crit Care Med 38.8 (2010): 1651-64.
- L Farogi., et al. “Antibiotic Therapy and Culture Results for Diabetic Versus Non-Diabetic Foot Woods”. J. Diab Foot Complications 5.1 (2013): 24-28.
- R Agarwal and DN Schwartz. “Procalcitonin to guide duration of antimicrobial therapy in intensive care units: a systematic review”. Clin Infect Dis 53.4 (2011): 379-87.
- Bassetti M., et al. “New approaches for empiric therapy in Gram-positive sepsis”. Minerva Anestesiol 77.8 (2011): 821-7.
- Murray P. “Molecular and non-molecular methods in the diagnosis of bloodstream infections. Symposium: Sepsis and bloodstream infections”. - XVI International Congress of the MACMACH on Antimicrobial Therapy. - Moscow (2014).