Antibiotics To Treat Foot Infections In People With Diabetes
Antibiotics to treat foot infections in people with diabetes We reviewed the effects on resolution of infection and safety of antibiotics given orally or intravenously (directly into the blood system) in people with diabetes that have a foot infection. One of the most frequent complications of people with diabetes is foot disorders, specially foot ulcers or wounds. These wounds can easily become infected, and are known as a diabetic foot infections (DFIs). If they are not treated, the infection can progress rapidly, involving deeper tissues and threatening survival of the limb. Sometimes these infections conclude with the affected limb needing to be amputated. Most DFIs require treatment with systemic antibiotics, that is, antibiotics that are taken orally, or are inserted straight into the bloodstream (intravenously), and affect the whole body. The choice of the initial antibiotic treatment depends on several factors such as the severity of the infection, whether the patient has received another antibiotic treatment for it, or whether the infection has been caused by a micro-organism that is known to be resistant to usual antibiotics (e.g. methicillin-resistant Staphylococcus aureus - better known as MRSA). The objective of antibiotic therapy is to stop the infection and ensure it does not spread. There are many antibiotics available, but it is not known whether one particular antibiotic - or type of antibiotic - is better than the others for treatment of DFIs. We searched through the medical literature up to March 2015 looking for randomised controlled trials (which produce the most reliable results) that compared different systemic antibiotics against each other, or against antibiotics applied only to the infected area (topical application), or against a fake medici Continue reading >>
Healing Wounds | Diabetic Connect
Howdy Vicki, How's the wound healing now? It's been 2 mos + since you originally posted this. How is your healing progressing? Keep the wound clean. Keep your sugars low in the normal range. Use hydrogen peroxide or {ouch} rubbing alcohol to disinfect the wound. Use a triple antibiotic {generic works and is cheap} if you feel the need. If a bandaid needs to be put on, make sure that it gets air through the bandaid or it will get worse. There are some cheap but really good ones at The Dollar Tree Store. They are white, self-adhesive, and come 6 to a box. But they let air in. Cutting myself shaving and not even feeling it is why my doctor told me to stop using regular razors and go to an electric one. I found several that I can use either in or out of the shower and got one. No more nicks shaving. As for helping to heal, can't really add more to what's already been said. I had one really nasty cut the last time I used a regular razor. It took longer to heal than I used to take but haven't really had any major problems with healing - YET! My biggest problem when I do get a cut is my allergy to adhesives. :( All I can say is have your doc take a look and see what s/he says. I'm an aloe vera fan myself. I burned myself really bad (3rd degree) on new years day. Started as a quarter sized area. Kept it happy for about 2 weeks when I ran out of silvadine I had from a foot treatment. I went to a dermatologist who wanted me to use biofine emulsion with the sivadine..I had an allergic reaction to it. He refered me to a plastic surgion who had me just use the silvadine again. 2 weeks or so later it was almost healed it was 3"x4" after the reaction before that. Just when I thought I was going to be fine I was told to use a neosporin type of stuffI reacted to that. It still itches a Continue reading >>
Diabetic Foot Infections Treatment & Management
LYRICA is contraindicated in patients with known hypersensitivity to pregabalin or any of its other components. Angioedema and hypersensitivity reactions have occurred in patients receiving pregabalin therapy. There have been postmarketing reports of hypersensitivity in patients shortly after initiation of treatment with LYRICA. Adverse reactions included skin redness, blisters, hives, rash, dyspnea, and wheezing. Discontinue LYRICA immediately in patients with these symptoms. There have been postmarketing reports of angioedema in patients during initial and chronic treatment with LYRICA. Specific symptoms included swelling of the face, mouth (tongue, lips, and gums), and neck (throat and larynx). There were reports of life-threatening angioedema with respiratory compromise requiring emergency treatment. Discontinue LYRICA immediately in patients with these symptoms. Antiepileptic drugs (AEDs) including LYRICA increase the risk of suicidal thoughts or behavior in patients taking AEDs for any indication. Monitor patients treated with any AED for any indication for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses showed clinical trial patients taking an AED had approximately twice the risk of suicidal thoughts or behavior than placebo-treated patients. The estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one patient for every 530 patients treated with an AED. The most common adverse reactions across all LYRICA clinical trials are dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, constipation, euphoric mood, balance Continue reading >>
Diabetic Ulcers Treatment & Management
LYRICA is contraindicated in patients with known hypersensitivity to pregabalin or any of its other components. Angioedema and hypersensitivity reactions have occurred in patients receiving pregabalin therapy. There have been postmarketing reports of hypersensitivity in patients shortly after initiation of treatment with LYRICA. Adverse reactions included skin redness, blisters, hives, rash, dyspnea, and wheezing. Discontinue LYRICA immediately in patients with these symptoms. There have been postmarketing reports of angioedema in patients during initial and chronic treatment with LYRICA. Specific symptoms included swelling of the face, mouth (tongue, lips, and gums), and neck (throat and larynx). There were reports of life-threatening angioedema with respiratory compromise requiring emergency treatment. Discontinue LYRICA immediately in patients with these symptoms. Antiepileptic drugs (AEDs) including LYRICA increase the risk of suicidal thoughts or behavior in patients taking AEDs for any indication. Monitor patients treated with any AED for any indication for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses showed clinical trial patients taking an AED had approximately twice the risk of suicidal thoughts or behavior than placebo-treated patients. The estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one patient for every 530 patients treated with an AED. The most common adverse reactions across all LYRICA clinical trials are dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, constipation, euphoric mood, balance Continue reading >>
High-tech Ointment Speeds Diabetic Wound Healing
Northwestern University researchers have developed a new high-tech but simple skin ointment that helps speed healing of wounds in diabetic patients. Chemist Chad A. Mirkin and dermatologist Amy S. Paller, M.D., created the topical treatment using new gene regulation technology that speeds the healing of stubborn and painful diabetes-related foot ulcers. The ointment, which was tested in laboratory animals, combines nanotechnology with a common commercial moisturizer to knock down a gene known to interfere with wound healing. "Finding a new way to effectively heal these resistant diabetic wounds is very exciting," said Dr. Paller, director of Northwestern's Skin Disease Research Center. "But, in addition, this study further proved that [the biotech ointment] can penetrate the skin barrier, a challenge that other therapies have been unable to conquer." Type 2 diabetes strikes more than 27 million Americans and many have chronic, non-healing skin wounds, and many undergo amputation. But the new ointment, simply applied to the edges of the wounds in diet-induced diabetic mice, helped heal the ulcers in less than two weeks. Blood circulation at the wound site in the treated animals also improved. The findings of the study were published this week by the Proceedings of the National Academy of Sciences. © 2017 NewsmaxHealth. All rights reserved. Continue reading >>
How To Care For Cuts And Scratches If You Have Diabetes
If you have diabetes , you may want to be a little more cautious about taking care of simple cuts, scratches, scrapes and bruises. In fact, skin care of any kind is important to your health. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy Bruises are the simplest to address. As long as the skin is not broken, you really dont need to do much of anything, except keep an eye on the area. A bruise is a bruise and will act like a bruise and go through the different changes in color over time, says dermatologist Christine Poblete-Lopez, MD . So being diabetic does not necessarily mean it will lengthen the way a bruise will resolve or not. If you have any type of laceration, however, you should keep a keen watch for infections because diabetics are more prone to developing infections, according to Dr. Poblete-Lopez. The signs of infection to look for around the cut are redness, warmth, tenderness and pus drainage. If you have any of those signs, you definitely need to bring it to the attention of your doctor, because you may need oral antibiotics, she says. There are some differences of opinion among diabetes experts and dermatologists when it comes to healing wounds, so we will take a look at both. When cleaning out a cut, for example, diabetes specialist Leann Olansky, MD, says to wash the cut with soap and waterandthen add an over-the-counter topical antibiotic such as Neosporin or a prescription ointment such as Bactroban to help prevent bacteria from entering into your subcutaneous tissue. The next step for Dr. Olansky is to cover the cut with a bandage to keep it moist so that it will heal faster. I dont think theres any advantage to keeping i Continue reading >>
Choice Of Wound Care In Diabetic Foot Ulcer: A Practical Approach
Go to: Definition Infection, ulceration or destruction of deep tissues associated with neurological abnormalities and various degrees of peripheral vascular diseases in the lower limb (World Health Organization definition, 1995). Risk factors Diabetic foot ulcers are a consequence of many factors including loss of protective sensation due to peripheral neuropathy where the feet become numb and the injury goes unnoticed. Also, arterial insufficiency complicates the neuropathic ulcer which leads to poor wound healing. Foot deformity and calluses can result in high plantar pressure, which results in additional risk. Mechanical stress at the wound site is hypothesized to affect wound healing[7]. Many other factors contribute to the risk of foot ulceration and its subsequent infection in patients with diabetes. Uncontrolled hyperglycemia, duration of diabetes, trauma, improper footwear, callus, history of prior ulcers/amputations, older age, blindness/impaired vision, chronic renal disease and poor nutrition have also been demonstrated to play a role in the pathogenesis and progression of diabetic foot ulceration. Infection further deteriorates the diabetic foot resulting in a non-healing chronic wound. Recently, vitamin D deficiency was proposed as a risk factor for diabetic foot infection[8]. Classification Based on the Red-Yellow-Black[9] wound classification system by Marion Laboratories, wounds can be classified as follows[10]: (1) Necrotic tissue-either dry or infected and usually black or dark green in color as shown in Figure 1A; (2) Sloughy tissue-combination of wound exudate and debris forming a glutinous yellow layer of tissue over the wound which is often mistaken for infection as shown in Figure 1B; (3) Granulating tissue-highly vascularized, red in color and so Continue reading >>
Tips For Diabetes Wound Care
A small cut can turn into a large complication when diabetes enters the picture. For one thing, diabetes can lead to a weakened immune system "so a simple cut or scrape can get infected easier than in someone who doesn’t have diabetes,” said Kiersten Weber, DPM, a podiatrist with the University of Oklahoma's Harold Hamm Diabetes Center in Oklahoma City. Neuropathy or nerve damage, one of the many diabetes side effects, also can play a role. Neuropathy can occur because extra sugar in the bloodstream can damage your nerves over time. “It usually starts in the smallest blood vessels, which are in the hands and feet,” explains Dr. Weber, and when you have neuropathy, you have decreased feeling in your feet. As a result, you may not feel pain if you have a cut or blister on your foot, and if you don’t know it’s there and don’t treat it, the sore could become infected. That’s why regularly inspecting your feet for cuts, scrapes, blisters, calluses, and other wounds is such an important part of diabetes care, she said. “If you can’t lift your feet, have someone do it for you and look at the bottom of your feet,” Weber said. “You also can use mirrors to inspect the bottom of your feet if you need.” Preventing Cuts and Scrapes Of course, the best way to protect yourself is to make a serious effort to prevent wounds. Make sure you never walk barefoot, even inside your home, and always wear good-fitting shoes. “I also tell my patients to check the inside of their shoes for stones,” Weber said. “If you have neuropathy, you could get a small stone in your shoe and not know it.” Protect your feet by letting your podiatrist handle even minor foot issues. Don’t try to remove calluses or warts yourself.You might be tempted to try commercial preparati Continue reading >>
Interleukin 2 Topical Cream For Treatment Of Diabetic Foot Ulcer: Experiment Protocol
Go to: Abstract It is estimated there are 2.9 million diabetic patients in the United Kingdom, and around 5%-7% of patients have diabetic ulcers. This number will continue to increase globally. Diabetic ulcers are a major economic burden on the healthcare system. More than £650 million is spent on foot ulcers or amputations each year, and up to 100 people a week have a limb amputated due to diabetes. In T1DM, the level of IL-2 is reduced, and hence, wound healing is in a prolonged inflammatory phase. It is not known if IL-2 topical cream can shorten the healing process in T1DM patients. The objective of this study is to understand the pathophysiology in type 1 diabetes (T1DM) and investigate possible future treatment based on its clinical features. The hypothesis is that IL-2 cream can speed up wound healing in NOD mice and that this can be demonstrated in a ten-week study. An experiment protocol is designed in a mouse model for others to conduct the experiment. The discussion is purely based on diabetic conditions; lifestyle influences like smoking and drinking are not considered. Skin incisions will be created on 20 nonobese diabetic (NOD) mice, and IL-2 topical cream will be applied in a 10-week study to prove the hypothesis. Mice will be randomly and equally divide into two groups with one being the control group. T1DM patients have a decreased number of T regulatory (Treg) cells and interleukin 2 (IL-2). These are the keys to the disease progression and delay in wound healing. Diabetic ulcer is a chronic wound and characterized by a prolonged inflammatory phase. If the experiment is successful, T1DM patients will have an alternative, noninvasive treatment of foot ulcers. In theory, patients with other autoimmune diseases could also use IL-2 topical cream for treat Continue reading >>
6 Key Factors In Treating A Diabetic Wound
Diabetic wound treatment methods require high attention to achieve healing. By 2030, it is estimated that more than 550 million people around the world will have diabetes. Approximately 25% of these diabetic patients will develop foot ulcers during their lifetime, which often require advanced diabetic wound treatment to prevent complications. To help achieve the optimal healing environment and protect against problems, there are six key factors to consider when treating diabetic wounds. 1. Wound Assessment Diabetic wounds fall into three categories: neuropathic, ischemic, and neuroischemic. Knowing the distinct features of each wound category is essential to identifying wound progression, infection, and healing. Failure to properly identify the type of wound that exists can lead to an ineffective diabetic wound treatment plan, causing long-term complications or amputation. 2. Tissue Debridement Wound debridement, or the removal of necrotic tissue from a wound, will reduce pressure, stimulate wound healing, allow for the inspection of underlying tissue, help with secretion or wound drainage, and optimize a wound dressing’s effectiveness. Clinicians typically recommend sharp debridement by scalpel or scissors, but there are other tissue-removal treatments they may recommend, including larval, autolytic, and ultrasonic. Only an experienced practitioner who knows which section of the tissue to remove without damaging blood vessels, nerves, or tendons should perform a debridement procedure. Understanding the importance of debridement to your diabetic wound treatment plan is often essential with advanced diabetic wounds. 3. Infection Control Infections are the top concern in any diabetic wound treatment plan. Due to the high morbidity and mortality rates associated with dia Continue reading >>
Antibiotics For Diabetic Wounds
Posted on July 16, 2013 | No Comments on Antibiotics for Diabetic Wounds One of the apparent and depressing complications of Diabetes is diabetic wound infections which usually occurs at the foot and lower extremity which has led to amputation. While diabetic foot infections is very common, they are often mismanaged, especially with regard to the use of antibiotics, which may entail know how on the basic diagnostics, culture techniques, pathogenic isolates, and the selection of appropriate antibiotic. Wound Infection commonly occurs among patients with type 2 diabetes secondary to a neuropathic ulceration. Neuropathy results to disorder and instability in the sensory, motor and autonomic function of the limbs resulting to tissue failure or trauma. Once the protective epidermal layer is debased, the underlying tissues become susceptible to germs, bacterial and fungal infection, which can extend rapidly to deeper tissues that would entail amputation or even lead to death. The type of antibiotics to be used to treat a diabetic would depend on the intensity of the wound. A mild diabetic food infection would normally require a 14 day treatment. Antibiotics to be used for this type of wound should equally be mild such as Bactrim DS bid Penicillin VK 500mg, ciprofloxacin 750mg or Levofloxacin 750mg. A complicated diabetic foot ulcer which would entail a patient to stay in the hospital for continuous monitoring would require stronger antibiotics such as ampicillin-sulbactam 1.5 to 3 grams, ticarcillin-clavulanic acid 3.1 grams, vancomycin 1 gram, doripenem 500mg among others. Generally, minor infections should be treated with narrow spectrum antibiotics while severe infections should be treated with broad spectrum antibiotics. Based on the above, recognizing the signs and symp Continue reading >>
Diabetes And Wounds: Caring For Sores
When you have diabetes, it's vital to treat foot injuries right away. Even minor wounds can turn into serious foot ulcers, which can cost you a foot -- or an entire leg -- if you don’t care for them quickly and thoroughly. These easy steps can prevent problems down the road. Common Causes What you put on your feet matters. "You can get a foot ulcer from something as simple as walking in new or tight-fitting shoes or getting a small pebble stuck in the shoe,” says Raul Guzman, MD, a vascular surgeon at the Joslin Diabetes Center in Boston. If you have diabetes, you may get a kind of nerve damage that stops the feeling in your feet. Doctors call this neuropathy. If you can’t feel your feet, you may not know you’re hurt, and a small cut or sore can turn into something bigger. Or you might have poor blood flow to your feet, which makes it hard for even minor cuts to heal. Your doctor can tell you whether you have nerve damage or blood-flow problems. Guzman says he can do a test that shows how blood moves through your body. If the results are normal, you can have standard wound-care treatments. “If the results of this blood-flow test are abnormal, that means you have poor circulation that needs to be repaired,” he says. Surgery can help. “We can use a balloon and stent,” Guzman says, “or we can do a bypass procedure, where we connect the artery above the blockage to one of the arteries in the calf or foot.” Wound Treatment Options If you do injure your foot, don't try to take care of it at home. Go to a wound-care center or your doctor, even for blisters, calluses, and scratches. “Put on some antibiotic ointment and see a wound center or your doctor, at the latest, the next day,” says Harold Brem, MD, chief of the wound healing and regenerative medici Continue reading >>
Topical Insulin Accelerates Wound Healing In Diabetes By Enhancing The Akt And Erk Pathways: A Double-blind Placebo-controlled Clinical Trial
Topical Insulin Accelerates Wound Healing in Diabetes by Enhancing the AKT and ERK Pathways: A Double-Blind Placebo-Controlled Clinical Trial 1 Department of Nursing, FCM, University of Campinas, Campinas, So Paulo, Brazil, 2 Department of Internal Medicine, FCM, University of Campinas, Campinas, So Paulo, Brazil, 3 Department of Cell and Developmental Biology, University of So Paulo, So Paulo, Brazil, University Hospital Hamburg-Eppendorf, Germany Conceived and designed the experiments: MHML JBCC LAV MJAS. Performed the experiments: MHML AMC LLA EPA FFP ACPT DMT AFMP MFS. Analyzed the data: LAV JBCC MAM MJAS MFS. Contributed reagents/materials/analysis tools: LAV JBCC MJAS. Wrote the paper: MHML MJAS AMC FFP. Received 2011 May 27; Accepted 2012 Apr 15. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. This article has been cited by other articles in PMC. Wound healing is impaired in diabetes mellitus, but the mechanisms involved in this process are virtually unknown. Proteins belonging to the insulin signaling pathway respond to insulin in the skin of rats. The purpose of this study was to investigate the regulation of the insulin signaling pathway in wound healing and skin repair of normal and diabetic rats, and, in parallel, the effect of a topical insulin cream on wound healing and on the activation of this pathway. We investigated insulin signaling by immunoblotting during wound healing of control and diabetic animals with or without topical insulin. Diabetic patients with ulcers were randomized to receive topical insulin or placebo in a prospective, double-blind and place Continue reading >>
How To Choose Appropriate Antibiotics For Diabetic Foot Infections
How To Choose Appropriate Antibiotics For Diabetic Foot Infections By Guy Pupp, DPM, FACFAS, and Chad Westphal, DPM Diabetes is clearly an epidemic in this country. According to the most recent statistics from the Centers for Disease Control and Prevention, 18.2 million people in the United States have the disease and 1.3 million new cases are diagnosed each year. Foot infection is the most common reason for lower extremity amputation and leads to billions of dollars a year in hospitalization costs in this country alone. Despite becoming almost commonplace, diabetic foot infections are often mismanaged, particularly with regard to antibiotics. The solution to this problem requires a strong knowledge of diagnostic essentials, culture techniques, common pathogenic isolates, and appropriate antibiotic selection and usage.1 Infection typically arises in patients with diabetes secondary to a neuropathic ulceration. Neuropathy causes disturbances in sensory, motor and autonomic function, leading to tissue breakdown from underlying foot pathology or trauma. Once the protective epidermal layer is violated, normal skin flora and environmental microorganisms are free to colonize in the underlying tissues. Depending on the patients vascular status, the proliferation and extension of bacteria into deeper tissues can be rapid and life threatening.2-5 Proper clinical evaluation of the diabetic foot is paramount. Upon the initial presentation of the patient with a diabetic ulceration, one must first examine the wound for local signs of infection including edema, warmth, surrounding erythema, ascending cellulitis, purulence, malodor, sinus tract formation, crepitation, depth of probe and pain. Clinicians should also check for systemic signs of infection including nausea, vomiting, fev Continue reading >>
How Raw Honey Helped Save My Diabetic Dad’s Foot
I generally try to avoid sensationalist posts with the words “amazing!” and “miracle treatment!” in them; however, this post is going to talk about a (for real) amazing miracle treatment that helped save my diabetic dad’s foot! I’m excited to share it with you today, in the hopes that perhaps it will reach others out there in need of the information. My dad has been a diabetic since he was 15 years old. At the time of his diagnosis, he knew exactly two people alive with diabetes. One had no legs and one was blind. Back then, in the 1950’s, one in five people died within 25 years of the diagnosis, one in four developed kidney failure, and about 90% suffered from diabetic retinopathy. (NIH source.) It was a grave thing for a kid to face, but my dad is tough. He kept going, taught himself several skills, including custom cabinet making from a set of books, and has lived a long and active life. Several years ago, he developed a sore on his foot that wouldn’t heal. In spite of heavy antibiotics and various medical treatments, it grew progressively worse until he ended up having two toes amputated. After the surgery, he had a team of excellent wound care doctors and was eventually able to resume his normal high energy activities. Last year, he developed a sore on the same foot, just like the one that caused him to lose those two toes. For eight months, the standard medical treatments and antibiotics failed to help and it looked like he would need to be referred to a surgeon again. One day, someone told him about their experience with treating a bad wound with raw honey. At that point, he was willing to try most anything. Being the go-to health nut with a ready stash of raw honey in the family, I was asked about it. I did some research and turned up this fascin Continue reading >>
