[Antibiotic treatment for diabetic foot. Advantages of intravenous regional route as alternative for systemic route]

Abstract

Diabetic angiopathy prevents adequate access of antibiotic agents to septic areas of the diabetic foot. We treated 22 such patients with antibiotics infused through a superficial vein associated to tourniquet occlusion of the limb (Group A). A control group of 47 patients, similar in age, sex and severity of diabetes received conventional systemic therapy (Group B). 45% of the patients exhibited occlusive arterial disease. Surgery was performed by the same team in both groups. Group A received regional anesthesia at the same time of the first antibiotic infusion. Group B received general or spinal anesthesia. Amputation was required in 5% of patients in Group A compared to 30% of patients in Group B (p < 0.02). Hospital stay was also significantly shorter in patients from Group A. No complications of this form of therapy were observed. Thus, regional antibiotic therapy may improve prognosis and facilitate management in patients with septic diabetic foot.