Arda Bilgin, Uysal Serhat, Taşbakan Meltem, Şimşir Ilgın Yıldırım, Öztürk Murat, Ertam İlgen, Uysal Ayşe, Ulusoy Sercan
Department of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, Turkey.
Buca Sey Demirsoy State Hospital, Izmir, Turkey.
Wounds. 2017 Nov;29(11):297-305. Epub 2017 Sep 26.
The aim of this study is to evaluate tigecycline for diabetic foot infections (DFIs).
In this prospective observational study, the investigators included patients who had consultation with the Diabetic Foot Council of Ege University Faculty of Medicine (Izmir, Turkey) between March 2013 and July 2015 and who used tigecycline during their treatment. Treatment success was assessed by design-specific criteria for each evaluation.
The study included 105 cases. Of those, 37 (35.2%) were women (mean [± standard deviation] age, 61.9 ± 11.9 years). The success rate of tigecycline treatment was 93.3% in mild infections, 56.2% in moderate, 57.7% in severe, and 61.9% in all cases. The authors found a 9-fold decrease (P = .046) in the success of tigecycline treatment among those who developed moderate or severe DFIs and a 6.4-fold decrease (P < .0001) among those who had arterial stenosis. For 33 (71.7%) of 46 (43.8%) patients who experienced a side effect, tigecycline treatment was continued as it could be tolerated.
If tigecycline is to be the treatment choice, extra attention must be paid to patients with arterial stenosis, severe DFIs, and side effects. The common disadvantage is the high side effect rate, especially nausea. However, it is generally not necessary to discontinue the medication in cases with nausea. Therefore, tigecycline may be used as a choice of therapy in mild DFIs.
本研究旨在评估替加环素治疗糖尿病足感染(DFIs)的效果。
在这项前瞻性观察研究中,研究人员纳入了2013年3月至2015年7月期间在伊兹密尔的土耳其埃杰大学医学院糖尿病足委员会就诊并在治疗期间使用替加环素的患者。根据特定设计标准对每次评估的治疗成功情况进行评估。
该研究纳入了105例病例。其中,37例(35.2%)为女性(平均[±标准差]年龄为61.9±11.9岁)。替加环素治疗轻度感染的成功率为93.3%,中度感染为56.2%,重度感染为57.7%,所有病例的成功率为61.9%。作者发现,发生中度或重度DFIs的患者中,替加环素治疗成功率下降了9倍(P = 0.046),而有动脉狭窄的患者中下降了6.4倍(P < 0.0001)。在46例(43.8%)出现副作用的患者中,有33例(71.7%)因可以耐受而继续使用替加环素治疗。
如果选择替加环素作为治疗药物,必须格外关注有动脉狭窄、重度DFIs和副作用的患者。常见的缺点是副作用发生率高,尤其是恶心。然而,一般情况下恶心时不必停药。因此,替加环素可作为轻度DFIs的治疗选择。