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914 results on '"Uçkay, İlker"'

15. Preoperative Antibiotic Administration Does Not Improve the Outcomes of Operated Diabetic Foot Infections †.

Author

Muri, Thaddaeus, Schöni, Madlaina, Waibel, Felix W. A., Altmann, Dominique, Sydler, Christina, Furrer, Pascal R., Napoli, Francesca, and Uçkay, İlker

Subjects
SOFT tissue infections, DIABETIC foot, SOFT tissue injuries, THERAPEUTICS, GENERAL practitioners
Abstract

Many patients with community-acquired diabetic foot infections (DFI) receive systemic (empirical) antibiotic treatments before surgical interventions, often by the general practitioner. Sometimes, hospital clinicians prescribe them before surgery to reduce the infection inoculum and preserve soft tissue for immediate wound closure in case of residual infection after surgery. In contrast, the international guidelines (IWGDF) advocate against presurgical antibiotic use in routine situations without severe progredient soft tissue infections and/or sepsis. We run several retrospective and prospective cohorts of DFI and retrospectively analyze the influence of presurgical antibiotic therapy (as binary (yes/no) or continuous (in days) variables) on failures after a combined surgical and medical treatment. In our large database, the presence, choice, administration routes, or duration of preoperative antibiotic therapy did not improve the postoperative outcomes of operated diabetic foot infections or prevent their failures. In turn, this lack of influence leaves space for enhanced antibiotic stewardship in the management of DFI. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Therapy for Non-Diabetic Foot Infections After Orthopedic Foot and Ankle Surgery: The Duration of Post-Debridement Antibiotic Treatment Does Not Alter Failure Risk.

Author

Scherer, Martina, Soldevila-Boixader, Laura, Yιldιz, İnci, Altorfer, Franziska C. S., Furrer, Pascal R., Beeler, Silvan, Wirth, Stephan H., Viehöfer, Arnd, and Uçkay, İlker

Subjects
SURGICAL site infections, LOGISTIC regression analysis, DIABETIC foot, SEX (Biology), WOUND care
Abstract

Despite growing numbers of scientific publications on the optimal antibiotic treatment for diabetic foot infections, the data on the adult population with non-diabetic (postsurgical) foot infections is limited. Therefore, one of the largest single-center databases at the Balgrist University Hospital in Zurich, Switzerland, was established between January 2014 and August 2022. Using a case–control study design, we retrospectively investigated failures of combined surgical and antibiotic therapy for surgical site foot infections (SSIs). Overall, 17.4% of the episodes experienced therapeutic failures, particularly in patients with infected ankle prostheses. However, age, biological sex, pathogens, the duration of post-debridement antibiotic treatment, the number of surgical debridements, or the use of negative-pressure wound care altered the failure risk. In the multivariate logistic regression analyses, the duration of postsurgical antibiotic use was completely indifferent (as a continuous variable with an odds ratio of 1.0 and a 95% confidence interval ranging from 0.96 to 1.03) when stratified into inter-tertiary groups. Our findings suggest that shorter courses of systemic antibiotics may be appropriate in non-diabetic adults, supporting better antibiotic stewardship. Ongoing randomized controlled trials are under way to investigate which patients might safely receive shorter antibiotic treatments for surgical site infections following elective foot and ankle procedures. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Assessment and management of diabetes-related foot infection according to the new International Working Group on the Diabetic Foot guidelines 2023-Multidisciplinary grand rounds

Author

Hon, Kay; https://orcid.org/0000-0002-8661-776X, Nobels, Frank, Senneville, Éric; https://orcid.org/0000-0002-5720-8908, Uçkay, Ilker; https://orcid.org/0000-0002-5552-0973, Maas, Mario, Fitridge, Robert; https://orcid.org/0000-0001-6258-5997, Hon, Kay; https://orcid.org/0000-0002-8661-776X, Nobels, Frank, Senneville, Éric; https://orcid.org/0000-0002-5720-8908, Uçkay, Ilker; https://orcid.org/0000-0002-5552-0973, Maas, Mario, and Fitridge, Robert; https://orcid.org/0000-0001-6258-5997

Abstract

Diabetes-related foot disease is a serious and common complication for people with diabetes mellitus. The gold standard care for a person with diabetes-related foot disease is the involvement of a multidisciplinary foot team engaged in evidence-based care. To date, there are seven International Working Group on the Diabetic Foot (IWGDF) guidelines published to assist healthcare providers in managing diabetes-related foot disease around the world. This review discusses the acute management of diabetes-related foot infection with insights from experts of various specialities (internal medicine, infectious disease, vascular surgery, radiology) with a discussion on the implementation of IWGDF guidelines in real life practice and the challenges that healthcare providers may face.

Published
2024

32. Interventions in the management of diabetes-related foot infections: A systematic review

Author

Peters, Edgar J G; https://orcid.org/0000-0002-3410-1227, Albalawi, Zaina, van Asten, Suzanne A, Abbas, Zulfiqarali G, Allison, Geneve, Aragón-Sánchez, Javier, Embil, John M, Lavery, Lawrence A, Alhasan, Majdi, Oz, Orhan, Uçkay, Ilker; https://orcid.org/0000-0002-5552-0973, Urbančič-Rovan, Vilma, Xu, Zhang-Rong, Senneville, Éric; https://orcid.org/0000-0002-5720-8908, Peters, Edgar J G; https://orcid.org/0000-0002-3410-1227, Albalawi, Zaina, van Asten, Suzanne A, Abbas, Zulfiqarali G, Allison, Geneve, Aragón-Sánchez, Javier, Embil, John M, Lavery, Lawrence A, Alhasan, Majdi, Oz, Orhan, Uçkay, Ilker; https://orcid.org/0000-0002-5552-0973, Urbančič-Rovan, Vilma, Xu, Zhang-Rong, and Senneville, Éric; https://orcid.org/0000-0002-5720-8908

Abstract

The optimal approaches to managing diabetic foot infections remain a challenge for clinicians. Despite an exponential rise in publications investigating different treatment strategies, the various agents studied generally produce comparable results, and high-quality data are scarce. In this systematic review, we searched the medical literature using the PubMed and Embase databases for published studies on the treatment of diabetic foot infections from 30 June 2018 to 30 June 2022. We combined this search with our previous literature search of a systematic review performed in 2020, in which the infection committee of the International Working Group on the Diabetic Foot searched the literature until June 2018. We defined the context of the literature by formulating clinical questions of interest, then developing structured clinical questions (Patients-Intervention-Control-Outcomes) to address these. We only included data from controlled studies of an intervention to prevent or cure a diabetic foot infection. Two independent reviewers selected articles for inclusion and then assessed their relevant outcomes and methodological quality. Our literature search identified a total of 5,418 articles, of which we selected 32 for full-text review. Overall, the newly available studies we identified since 2018 do not significantly modify the body of the 2020 statements for the interventions in the management of diabetes-related foot infections. The recent data confirm that outcomes in patients treated with the different antibiotic regimens for both skin and soft tissue infection and osteomyelitis of the diabetes-related foot are broadly equivalent across studies, with a few exceptions (tigecycline not non-inferior to ertapenem [±vancomycin]). The newly available data suggest that antibiotic therapy following surgical debridement for moderate or severe infections could be reduced to 10 days and to 3 weeks for osteomyelitis following surgical debridement of bone. Similar outcomes w

Published
2024

36. Antibiotic Stewardship in the Management of Infected Diabetic Foot Ulcer Disease in Less Developed Countries.

Author

Abbas, Zulfiqarali G., Gangji, Raidah R., and Uçkay, Ilker

Subjects
DIABETIC foot, ANTIMICROBIAL stewardship, FOOT diseases, GRAM'S stain, DEVELOPING countries, MEDICAL care, DRUG prescribing
Abstract

Background: Diabetic foot ulcers in developing countries often become infected. The healthcare systems are often not equipped to conduct the culture and the sensitivity tests required for prescribing a targeted antibiotic treatment for diabetic foot infection (DFI). Methods: We evaluate antibiotic stewardship programmes for DFIs, at every level of health care, with an emphasis on resource‐poor settings such as in Africa. Results: The management of DFI very often is adapted to the financial and practical realities of the resource‐poor regions. The application of the point‐of‐care Gram stain of deep tissue samples is efficient, rapid, low cost and ubiquitously available. Upon the identification of the predominant pathogen in the Gram stain, a semi‐quantitative preemptive antibiotic treatment can be started in accordance with the World Health Organization Aware, Watch and Restrict Essential Medicine List. This list is catered to every country and is a powerful tool. However, some basic knowledge of the local microbiological epidemiology is necessary to choose the most appropriate agent. We report our experience on using the rapidly available Gram stain for narrowing the preemptive choice of listed antibiotic agents, as an economic tool for antibiotic stewardship in DFIs. Conclusions: In the practical and resource‐saving management of DFI, the 'therapeutic' use of Gram stains is not common in resource‐rich countries but should be added to the arsenal of the general efforts for antibiotic stewardship. [ABSTRACT FROM AUTHOR]

Published
2024
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42. Interventions in the management of diabetes‐related foot infections: A systematic review

Author

Peters, Edgar J. G., primary, Albalawi, Zaina, additional, van Asten, Suzanne A., additional, Abbas, Zulfiqarali G., additional, Allison, Geneve, additional, Aragón‐Sánchez, Javier, additional, Embil, John M., additional, Lavery, Lawrence A., additional, Alhasan, Majdi, additional, Oz, Orhan, additional, Uçkay, Ilker, additional, Urbančič‐Rovan, Vilma, additional, Xu, Zhang‐Rong, additional, and Senneville, Éric, additional

Published
2023
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43. IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023)

Author

Senneville, Éric, primary, Albalawi, Zaina, additional, van Asten, Suzanne A, additional, Abbas, Zulfiqarali G, additional, Allison, Geneve, additional, Aragón-Sánchez, Javier, additional, Embil, John M, additional, Lavery, Lawrence A, additional, Alhasan, Majdi, additional, Oz, Orhan, additional, Uçkay, Ilker, additional, Urbančič-Rovan, Vilma, additional, Xu, Zhang-Rong, additional, and Peters, Edgar J G, additional

Published
2023
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45. Diagnosis of infection in the foot of patients with diabetes: A systematic review

Author

Senneville, Éric, primary, Albalawi, Zaina, additional, van Asten, Suzanne A., additional, Abbas, Zulfiqarali G., additional, Allison, Geneve, additional, Aragón‐Sánchez, Javier, additional, Embil, John M., additional, Lavery, Lawrence A., additional, Alhasan, Majdi, additional, Oz, Orhan, additional, Uçkay, Ilker, additional, Urbančič‐Rovan, Vilma, additional, Xu, Zhang‐Rong, additional, and Peters, Edgar J. G., additional

Published
2023
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