Does PAD and microcirculation status impact the tissue availability of intravenously administered antibiotics in patients with infected diabetic foot? Results of the DFIATIM substudy
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F67985904%3A_____%2F24%3A00586271" target="_blank" >RIV/67985904:_____/24:00586271 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11120/24:43927061 RIV/00216208:11130/24:10480488 RIV/00023001:_____/24:00084814
Result on the web
<a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1326179/full" target="_blank" >https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1326179/full</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.3389/fendo.2024.1326179" target="_blank" >10.3389/fendo.2024.1326179</a>
Alternative languages
Result language
angličtina
Original language name
Does PAD and microcirculation status impact the tissue availability of intravenously administered antibiotics in patients with infected diabetic foot? Results of the DFIATIM substudy
Original language description
Aims/hypothesis: The aim of this substudy (Eudra CT No:2019-001997-27) was to assess ATB availability in patients with infected diabetic foot ulcers (IDFUs) in the context of microcirculation and macrocirculation status. Methods: For this substudy, we enrolled 23 patients with IDFU. Patients were treated with boluses of amoxicillin/clavulanic acid(AMC)(12patients) or ceftazidime(CTZ)(11patients). After induction of a steady ATB state, microdialysis was performed near the IDFU. Tissue fluid samples from the foot and blood samples from peripheral blood were taken within 6 hours. ATB potential efficacy was assessed by evaluating the maximum serum and tissue ATB concentrations(C-max and Cmax-tissue)and the percentage of time the unbound drug tissue concentration exceeds the minimum inhibitory concentration (MIC)(>= 100% (tissue) and >= 50%/60% (tissue) fT>MIC). Vascular status was assessed by triplex ultrasound, ankle-brachial and toe-brachial index tests, occlusive plethysmography comprising two arterial flow phases, and transcutaneous oxygen pressure(TcPO2). Results: Following bolus administration, the C-max of AMC was 91.8 +/- 52.5 mu gmL(-1) and the Cmax-tissue of AMC was 7.25 +/- 4.5 mu gmL(-1)(P<0.001). The C-max for CTZ was 186.8 +/- 44.1 mu gmL(-1) and the Cmax-tissue of CTZ was 18.6 +/- 7.4 mu gmL(-1)(P<0.0001). Additionally, 67% of patients treated with AMC and 55% of those treated with CTZ achieved tissue fT>MIC levels exceeding 50% and 60%, respectively. We observed positive correlations between both Cmax-tissue and AUC(tissue) and arterial flow. Specifically, the correlation coefficient for the first phase was r=0.42 (P=0.045), and for the second phase, it was r=0.55(P=0.01)and r=0.5(P=0.021). Conclusions: Bactericidal activity proved satisfactory in only half to two-thirds of patients with IDFUs, an outcome that appears to correlate primarily with arterial flow.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
10606 - Microbiology
Result continuities
Project
<a href="/en/project/NU20-01-00078" target="_blank" >NU20-01-00078: Rationalisation of ATB Therapy in Diabetic Foot Infection and its Impact on the Intestinal Microbiota</a><br>
Continuities
P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)
Others
Publication year
2024
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Frontiers in Endocrinology
ISSN
1664-2392
e-ISSN
1664-2392
Volume of the periodical
15
Issue of the periodical within the volume
May 7
Country of publishing house
CH - SWITZERLAND
Number of pages
11
Pages from-to
1326179
UT code for WoS article
001227729200001
EID of the result in the Scopus database
2-s2.0-85193637276