Somme D, Reny J L, Mainardi J L
Service de Gériatrie, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015, Paris, France.
Ann Med Interne (Paris). 2001 Sep;152(5):305-16.
Infection is a common problem in diabetic patients with foot ulcers. The diagnosis of infection is not always easy to establish, but must be made for proper therapeutic decision making. In addition to local care, search for arteriopathy and strict control of blood glucose, treatment of infected foot ulcers requires an appropriate anti-infectious strategy. We developed diagnostic and therapeutic decisional algorithms from data available in the literature in order to establish a management strategy for different clinical situations. The fundamental role of clinical assessment is underlined and the different causal microorganisms are recalled, together with the anti-microbial activity and bone concentrations of the main antibiotics used. An optimal anti-infection work-up can undoubtedly significantly reduce the number of amputations in diabetic patients.
感染是糖尿病足溃疡患者的常见问题。感染的诊断并非总是容易确定,但为了做出恰当的治疗决策必须进行诊断。除了局部护理、检查是否存在动脉病变以及严格控制血糖外,治疗感染性足溃疡还需要适当的抗感染策略。我们根据文献中的现有数据制定了诊断和治疗决策算法,以便为不同临床情况建立管理策略。强调了临床评估的重要作用,回顾了不同的致病微生物以及所用主要抗生素的抗菌活性和骨浓度。最佳的抗感染检查无疑可以显著减少糖尿病患者的截肢数量。