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足部感染是一种严重的糖尿病并发症,发病率高,甚至危及生命。对于最近没有接受过抗生素治疗的患者,使用抗生素治疗轻度感染,往往只需针对葡萄球菌和链球菌。对于中度或重度慢性感染的患者,或者以前抗生素治疗无效的患者,通常更多用经验治疗。相当大比例的糖尿病足感染是骨感染,这增加了治疗的难度,有的病变甚至需要截肢。越来越多的证据表明,糖尿病足骨髓炎采用非手术治疗,也是有效果的,但是药物的最佳选择、给药途径和疗程尚未被确定。本文探讨了用于治疗糖尿病足感染的抗生素(经典药和新药)的潜在作用,包括:厄他培南(ertapenem),万古霉素(vancomycin),莫西沙星(moxifloxacin),达托霉素(daptomycin),特拉万星(telavancin)和替格环素(tigecycline),以及几种新研发的药物。
Foot infection is a serious complication of diabetes, high incidence, and even life-threatening. For patients who have not been treated with antibiotics recently, antibiotics are often used to treat mild infections and only for staphylococci and streptococci. Patients with moderate or severe chronic infections, or those who have previously failed to respond to antibiotics, are usually treated more empirically. A significant proportion of diabetic foot infections are bone infections, which increase the difficulty of treatment and some even require amputation. There is growing evidence that non-surgical treatment of diabetic foot osteomyelitis is also effective, but the optimal choice of drug, route of administration and course of treatment have not yet been determined. This article explored the potential effects of antibiotics (classical and new drugs) used to treat diabetic foot infections, including: ertapenem, vancomycin, moxifloxacin, daptomycin daptomycin, telavancin and tigecycline, as well as several newly developed drugs.