Paper of the week: Stopping antibiotics after surgical amputation in diabetic foot and ankle infections-A daily practice cohort. Rossel A, Lebowitz D, Gariani K, Abbas M, Kressmann B, Assal M, Tscholl P, Stafylakis D, Uçkay I. Endocrinol Diabetes Metab. 2019 Feb 6;2(2): e00059. doi: 10.1002/edm2.59. eCollection 2019 Apr.
Summary by Dr. Sreeram Penna
This is a retrospective cohort study included adult diabetic foot and ankle infection patients who underwent amputation. Researchers studied benefits of continuing antibiotics after amputation. Overall 482 episodes in 258 patients were included in the study. Osteomyelitis was diagnosed in 239 cases. Median duration of antibiotics post amputation was 7 days. In 109 episodes antibiotic was discontinued immediately after surgery. Using multivariate analysis researchers concluded that neither duration of post-operative antibiotics (Hazards ratio: 1.0; CI 0.99 – 1.01) nor immediate discontinuation (Hazards ratio: 0.9; CI 0.5 -1.5) altered overall failure rate. Researchers also stressed importance of amputation with clear margins.