Does PAD and microcirculation status impact the tissue availability of intravenously administered antibiotics in patients with infected diabetic foot? Results of the DFIATIM substudy

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11120/24:43927061 RIV/00216208:11130/24:10480488 RIV/00023001:_____/24:00084814

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Does PAD and microcirculation status impact the tissue availability of intravenously administered antibiotics in patients with infected diabetic foot? Results of the DFIATIM substudy

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Does PAD and microcirculation status impact the tissue availability of intravenously administered antibiotics in patients with infected diabetic foot? Results of the DFIATIM substudy

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

10606 - Microbiology

Projekt

<a href="/cs/project/NU20-01-00078" target="_blank" >NU20-01-00078: Racionalizace antibiotické terapie infekce u syndromu diabetické nohy a její vztah ke gastrointestinálnímu traktu</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Frontiers in Endocrinology

ISSN

1664-2392

e-ISSN

1664-2392

Svazek periodika

15

Číslo periodika v rámci svazku

May 7

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

11

Strana od-do

1326179

Kód UT WoS článku

001227729200001

EID výsledku v databázi Scopus

2-s2.0-85193637276