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Oral amoxicillin‐clavulanate for treating diabetic foot infections
Author(s) -
Gariani Karim,
Lebowitz Dan,
Kressmann Benjamin,
von Dach Elodie,
Sendi Parham,
Waibel Felix,
Berli Martin,
Huber Tanja,
Lipsky Benjamin A.,
Uçkay Ilker
Publication year - 2019
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13651
Subject(s) - medicine , interquartile range , osteomyelitis , amoxicillin , retrospective cohort study , amputation , diabetic foot , surgery , antibiotics , diabetes mellitus , microbiology and biotechnology , biology , endocrinology
Aim To assess amoxicillin‐clavulanate (AMC) for the oral therapy of diabetic foot infections (DFIs), especially for diabetic foot osteomyelitis (DFO). Methods We performed a retrospective cohort analysis among 794 DFI episodes, including 339 DFO cases. Results The median duration of antibiotic therapy after surgical debridement (including partial amputation) was 30 days (DFO, 30 days). Oral AMC was prescribed for a median of 20 days (interquartile range, 12‐30 days). The median ratio of oral AMC among the entire antibiotic treatment was 0.9 (interquartile range, 0.7‐1.0). After a median follow‐up of 3.3 years, 178 DFIs (22%) overall recurred (DFO, 75; 22%). Overall, oral AMC led to 74% remission compared with 79% with other regimens (χ 2 ‐test; P = 0.15). In multivariate analyses and stratified subgroup analyses, oral AMC resulted in similar clinical outcomes to other antimicrobial regimens, when used orally from the start, after an initial parenteral therapy, or when prescribed for DFO. Conclusions Oral AMC is a reasonable option when treating patients with DFIs and DFOs.