Document Detail

Outpatient management of uncomplicated lower-extremity infections in diabetic patients.
MedLine Citation:
PMID:  2183732     Owner:  NLM     Status:  MEDLINE    
Most diabetic foot infections are believed to be caused by both aerobic and anaerobic bacteria and to require hospitalization and parenteral antimicrobial therapy. We prospectively evaluated diabetic patients with non-limb-threatening lower-extremity infections not yet treated with antibiotics. The patients were randomized to outpatient treatment with oral clindamycin hydrochloride or cephalexin for 2 weeks and evaluated every 3 to 7 days. In 56 assessable patients, curettage yielded a mean of 2.1 microorganisms. Aerobic gram-positive cocci were isolated in 50 cases (89%), and were the sole pathogen in 21 (42%) of these. Aerobic gram-negative bacilli and anaerobes were isolated in 20 (36%) and 7 (13%) cases, respectively, and almost always in polymicrobial infections. Fifty-one infections (91%) were eradicated, 42 (75%) after 2 weeks of treatment; only 5 (9%) were initially treatment failures, and 3 (5%) were subsequently cured with further outpatient oral antibiotic treatment. After a mean follow-up of 15 months, no further treatment was required in 43 (84%) of the cured patients. Previously untreated lower-extremity infections in diabetic patients are usually caused by aerobic gram-positive cocci, and generally respond well to outpatient management with oral antibiotic therapy.
B A Lipsky; R E Pecoraro; S A Larson; M E Hanley; J H Ahroni
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  150     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1990-05-14     Completed Date:  1990-05-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  790-7     Citation Subset:  AIM; IM    
Division of General Internal Medicine, University of Washington School of Medicine, Seattle.
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MeSH Terms
Ambulatory Care
Bacterial Infections / drug therapy*,  etiology
Cephalexin / therapeutic use*
Clindamycin / therapeutic use*
Diabetes Mellitus, Type 1 / complications*
Diabetes Mellitus, Type 2 / complications*
Foot Diseases / drug therapy*,  etiology
Gram-Positive Bacteria
Middle Aged
Prospective Studies
Randomized Controlled Trials as Topic
Reg. No./Substance:
15686-71-2/Cephalexin; 18323-44-9/Clindamycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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