Efficacy of ertapenem for secondary treatment of diabetic foot infections .

UNLABELLED:  Background. The diabetic foot is a common site of infections that frequently result in significant patient morbidity and mortality. Antibiotic treatment is an important part of therapy with selection of the specific agent depending on the stage of ulceration. Recently, ertapenem has entered use as first line therapy for moderate to severe diabetic foot infections. The following prospective study recounts the experience of using ertapenem as tertiary salvage therapy following failure of first and second-line antibiotics.

METHODS: Forty consecutive patients with diabetic foot ulcers (IDSA classification moderate-severe), 28 with soft tissue infections alone, 12 with concomitant osteomyelitis, were included in the study. Patients were referred from the diabetic foot clinic at the authors' institution after failure of treatment with cephalexin and ciprofloxacin/clindamycin combination, and were treated with ertapenem 1-g daily intravenously (IV). Endpoints were significant clinical improvement (resolution of fever, leukocytosis, surrounding erythema, and purulent discharge).

RESULTS: Clinical improvement was noted in all 28 individuals with soft tissue infections-all of these individuals had complete ulcer closure after a mean of 30 ± 8 treatment days. Of the 12 patients with concomitant osteomyelitis, only 25% required surgical intervention. Nine individuals were cured following a mean of 60 ± 15 treatment days of home IV antibiotic therapy.

CONCLUSION: Ertapenem is an efficacious, easy to use, and cost saving antibiotic for the treatment of diabetic foot infections that have failed therapy with traditional antibiotics.