Tascini Carlo, Menichetti F, Gemignani G, Palumbo F, Leonildi A, Tedeschi A, Piaggesi A
Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
Int J Low Extrem Wounds. 2006 Sep;5(3):213-6. doi: 10.1177/1534734606291676.
The evaluation of the safety and effectiveness of colistin in association with rifampin and imipenem in 1 diabetic patient with severe diabetic foot infection (DFI) due to multidrug-resistant (MDR) Pseudomonas aeruginosa, complicated by osteomyelitis, is presented in this "Case Report". The patient received colistin after other ineffective antimicrobial treatment when an MDR P aeruginosa strain was isolated by cultural examination, together with a multidisciplinary care approach including surgical debridement and adequate offloading. The efficacy of combination colistin plus rifampin plus imipenem was observed with a checkerboard method and bactericidal activity of the serum. The patient received colistin combination therapy for 6 weeks with cure of the infection and without renal toxicity. These data suggest that colistin, in combination with rifampin and imipenem, is safe and effective, in promoting healing in DFI due to MDR P aeruginosa and suggest the need for controlled clinical studies.
本“病例报告”介绍了对1例因多重耐药（MDR）铜绿假单胞菌引起严重糖尿病足感染（DFI）并伴有骨髓炎的糖尿病患者，使用黏菌素联合利福平及亚胺培南治疗的安全性和有效性评估。在其他抗菌治疗无效后，通过培养检查分离出MDR铜绿假单胞菌菌株时，该患者接受了黏菌素治疗，同时采用了包括手术清创和适当减负在内的多学科护理方法。用棋盘法和血清杀菌活性观察了黏菌素联合利福平加亚胺培南的疗效。该患者接受黏菌素联合治疗6周，感染治愈且无肾毒性。这些数据表明，黏菌素联合利福平及亚胺培南在促进MDR铜绿假单胞菌所致DFI愈合方面是安全有效的，并提示需要进行对照临床研究。
