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Staphylococcus aureus-Related Diabetic Osteomyelitis: Medical or Surgical Management? A French and Spanish Retrospective Cohort
- Source :
- The international journal of lower extremity wounds. 14(3)
- Publication Year :
- 2014
-
Abstract
- Staphylococcus aureus is the main cause of diabetic foot osteomyelitis (DFO) and can be treated medically or by surgery. We investigated the outcome of consecutive patients with a diagnosis of S aureus DFO retrospectively in 4 hospitals according to the type of management, medical (including debridement at bedside) or surgical. The outcome was classified as either favorable or failure (relapse, impaired wound healing, or amputation). Seventy-four patients with S aureus DFO, including 26 with methicillin-resistant S aureus, were included with a mean duration of follow-up of 21 ± 1 months. As part of the initial treatment, 47% underwent bone surgery followed with a short course of antibiotic. Others were treated with antibiotic therapy alone with bedside debridement. The outcome was favorable for 84% of these patients, with similar rates in the surgical and medical groups (80% vs 87%, P > .05). Patients in the medical group were less frequently hospitalized (49% vs 94%, P < .001) and had a shorter length of hospital stay (17 ± 3 vs 50 ± 12 days, P = .004). Patients in the surgery group received a shorter course of antibiotic therapy (10 ± 2 vs 11 ± 1 weeks, P = .001) with fewer side effects (9% vs 33%, P = .01). The type of management was not associated with subsequent new episode of noncontiguous DFO, which developed in 32% of cases. In conclusion, except significant differences in duration of hospitalization and antibiotic therapy, medical and surgical management of S aureus DFO had similar outcomes with a cure rate >80%.
- Subjects :
- Male
medicine.medical_specialty
Staphylococcus aureus
Time Factors
medicine.drug_class
medicine.medical_treatment
Antibiotics
Decision Making
medicine.disease_cause
Amputation, Surgical
medicine
Humans
Aged
Debridement
business.industry
Osteomyelitis
Incidence
Retrospective cohort study
General Medicine
Staphylococcal Infections
medicine.disease
Diabetic foot
Diabetic Foot
Surgery
Anti-Bacterial Agents
Survival Rate
Treatment Outcome
Amputation
Spain
Bone surgery
Female
France
business
Subjects
Details
- ISSN :
- 15526941
- Volume :
- 14
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The international journal of lower extremity wounds
- Accession number :
- edsair.doi.dedup.....ef055049479150f66740a464cd36dde1