Document Detail


Outpatient management of uncomplicated lower-extremity infections in diabetic patients.
MedLine Citation:
PMID:  2183732     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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    
Affiliation:
Division of General Internal Medicine, University of Washington School of Medicine, Seattle.
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MeSH Terms
Descriptor/Qualifier:
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
Humans
Male
Middle Aged
Prospective Studies
Randomized Controlled Trials as Topic
Chemical
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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