Memon Munawer Latif, Ikram Muhammad, Azhar Muhammad, Balouch Varda
Muawer Latif Memon, Assistant Professor Surgery, POF Hospital, Wah Cantt, Pakistan.
Muhammad Ikram, Assistant Professor Orthopedics, POF Hospital, Wah Cantt, Pakistan.
Pak J Med Sci. 2022 Mar-Apr;38(3Part-I):663-667. doi: 10.12669/pjms.38.3.3277.
To compare efficacy of systemic antibiotics alone and combination of systemic antibiotics with gentamicin cream in diabetic foot infections.
Prospective Observational Study was conducted at Department of Surgery, Pakistan Ordinance Factories (POF) Hospital, Wah Cantt for duration of two years (January 2018-December 2019). A sample size of 140 diabetic foot infection patients (70 patients in each group) was calculated using WHO calculator. DFI patients were selected through non probability (consecutive) sampling technique. All patients signed consent forms before participation into study. Patients were randomly divided into two group (computer generated random number table); Group-A patients were given systemic antibiotics alone while Group-B was given combination of gentamicin cream and systemic antibiotics. SPSS version 24 was utilized for analysis purpose. Chi-square test was applied in our study. Results with p value ≤0.05 found significant.
Total 140 patients were included in study. There were 87(62.1%) male and 53(37.9%) females in our data. Mean age of patients was 46 years±11.3SD. Group-B (combination of gentamicin and systemic antibiotics) showed significant reduction in inflammation (p=0.03), culture negativity(p=0.001), increase clinical cure (p=0.02) and pathological eradication (p=0.03) as compared to Group-A (systemic antibiotics alone). Gender, age and duration of diabetes mellitus had insignificant association with outcomes (p>0.05).
Diabetic foot infections are significant contributors of morbidity in our country. Combination of gentamicin cream with systemic antibiotics is highly effective in inflammation reduction, increasing clinical cure rate and pathological eradication as compared to systemic antibiotics alone in diabetic foot infections. Early identification of risk factors, proper patients care and multidisciplinary approach for diabetic foot infections prevention is required.
比较单纯全身使用抗生素与全身使用抗生素联合庆大霉素乳膏治疗糖尿病足感染的疗效。
在巴基斯坦瓦赫坎特市巴基斯坦 Ordnance Factories（POF）医院外科进行了为期两年（2018年1月至2019年12月）的前瞻性观察研究。使用世界卫生组织计算器计算出140例糖尿病足感染患者的样本量（每组70例患者）。通过非概率（连续）抽样技术选择糖尿病足感染患者。所有患者在参与研究前签署了同意书。患者被随机分为两组（计算机生成随机数表）；A组患者仅接受全身使用抗生素，而B组患者接受庆大霉素乳膏与全身使用抗生素的联合治疗。使用SPSS 24版进行分析。本研究采用卡方检验。p值≤0.05的结果具有显著性。
共有140例患者纳入研究。我们的数据中有87例（62.1%）男性和53例（37.9%）女性。患者的平均年龄为46岁±11.3标准差。与A组（仅全身使用抗生素）相比，B组（庆大霉素与全身使用抗生素联合）在炎症减轻（p = 0.03）、培养转阴（p = 0.001）、临床治愈率提高（p = 0.02）和病理清除率提高（p = 0.03）方面均表现出显著差异。性别、年龄和糖尿病病程与治疗结果无显著关联（p>0.05）。
糖尿病足感染是我国发病的重要因素。与单纯全身使用抗生素相比，庆大霉素乳膏与全身使用抗生素联合在减轻糖尿病足感染炎症、提高临床治愈率和病理清除率方面非常有效。需要早期识别危险因素、对患者进行适当护理以及采用多学科方法预防糖尿病足感染。
