Diabetic Foot: The Possibilities of Antibacterial and Antioxidant Therapy

Abstract

The article presents the results of a microbiological study of wound fluid from 97 patients with diabetes mellitus. Of 126 isolated strains, the leading pathogens were bacteria of the genus Staphylococcus (54%), Enterococcus (14%), and Streptococcus (13%). The leading pathogen among gram-negative bacteria was Escherichia coli (5%). Nonfermentative gram-negative bacteria amounted for 3% and were represented by Pseudomonas aeruginosa (2%) and Asintobacter (1%) bacteria. High activity of amoxiclav, imipenem and cefoperazone/sulbactam in the majority of both gram-positive and gram-negative cultures was noted. Sensitivity to fluoroquinolones ranged from 75% to 100%. Levofloxacin and moxifloxacin were the most active. To treat 14 patients, we used an intraarterial method of continuous infusion of levofloxacin (500 mg/day) and sequential administration of isoximere bromide (polyoxidonium - PO, 12 mg/day) through a permanent implanted catheter device. Complex therapy led to a rapid regression of clinical manifestations of the infectious and pain syndromes followed by granulation and epithelization of the wound. Undesirable effects are not recorded in any patient throughout the course of therapy (10-12 days).

Keywords

• diabetes mellitus
• diabetic foot syndrome
• pathogens
• complex therapy
• levofloxacin
• polyoxidonium
• intraarterial administration
• port catheter