Local Antibiotic Delivery Systems: Current and Future Applications for Diabetic Foot Infections.

Journal article


Markakis, K, Faris, AR, Sharaf, H, Faris, B, Rees, SM and Bowling, FL (2018). Local Antibiotic Delivery Systems: Current and Future Applications for Diabetic Foot Infections. International Journal of Lower Extremity Wounds.
AuthorsMarkakis, K, Faris, AR, Sharaf, H, Faris, B, Rees, SM and Bowling, FL
Abstract

Foot infections are common among diabetic patients with peripheral neuropathy and/or peripheral arterial disease, and it can be the pivotal event leading to a minor or major amputation of the lower extremity. Treatment of diabetic foot infections, especially deep-seated ones, remains challenging, in part because impaired blood perfusion and the presence of biofilms can impair the effectiveness of systemic antibiotics. The local application of antibiotics is an emerging field in the treatment of diabetic foot infections, with demonstrable advantages. These include delivery of high concentrations of antibiotics in the affected area, limited systemic absorption, and thus negligible side effects. Biodegradable vehicles, such as calcium sulfate beads, are the prototypical system, providing a good elution profile and the ability to be impregnated with a variety of antibiotics. These have largely superseded the nonbiodegradable vehicles, but the strongest evidence available is for calcium bead implantation for osteomyelitis management. Natural polymers, such as collagen sponge, are an emerging class of delivery systems, although thus far, data on diabetic foot infections are limited. There is recent interest in the novel antimicrobial peptide pexiganan in the form of cream, which is active against most of the microorganisms isolated in diabetic foot infections. These are promising developments, but randomized trials are required to ascertain the efficacy of these systems and to define the indications for their use. Currently, the role of topical antibiotic agents in treating diabetic foot infections is limited and outside of routine practice.

Keywordsdiabetic foot infection; diabetic foot ulcer; topical antibiotics; 1103 Clinical Sciences; Dermatology & Venereal Diseases
Year2018
JournalInternational Journal of Lower Extremity Wounds
PublisherLondon South Bank University
ISSN1552-6941
Digital Object Identifier (DOI)doi:10.1177/1534734618757532
Publication dates
Print01 Feb 2018
Publication process dates
Deposited24 Mar 2018
Accepted01 Jan 2018
Accepted author manuscript
License
CC BY 4.0
Permalink -

https://openresearch.lsbu.ac.uk/item/86w15

  • 7
    total views
  • 36
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Related outputs

Higher degrees in nursing: traditional research PhD or professional doctorate?
Rees, S., Ousey, K., Koo, K., Ahmad, N. and Bowling, F. (2019). Higher degrees in nursing: traditional research PhD or professional doctorate? British Journal of Nursing. 28 (14), pp. 940-945.
A practical guide to prescribing statins in primary care
Rees, SM (2018). A practical guide to prescribing statins in primary care. Practice Nursing. 29 (8).
Gabapentin and pregabalin in the pain setting: all you need to know
Rees, SM (2018). Gabapentin and pregabalin in the pain setting: all you need to know. Nurse Prescribing. 16 (7).
Barriers to implementing the Sepsis Six guidelines in an acute hospital setting
Breen, SJ and Rees, SM (2018). Barriers to implementing the Sepsis Six guidelines in an acute hospital setting. British Journal of Nursing. 27 (9), pp. 473-478.
Buprenorphine—an atypical opioid: All you need to know
Rees, SM (2017). Buprenorphine—an atypical opioid: All you need to know. Nurse Prescribing. 15 (8), pp. 402-408.
Drug therapies to manage nausea and vomiting
Rees, SM (2018). Drug therapies to manage nausea and vomiting. Nurse Prescribing. 16 (1), pp. 37-44.