Our colleagues at The Balgrist have another excellent contribution to the literature.
Summary:
- Objective: Summarize frequent and severe AEs of antibiotic use in diabetic foot infections (DFIs) from global prospective trials and observational studies
- Most frequent AEs: Gastrointestinal intolerances (5%-22%)
- More common with prolonged oral beta-lactam or clindamycin, or higher dose of tetracyclines
- Symptomatic colitis due to Clostridium difficile: Variable depending on antibiotic (0.5%-8%)
- Serious AEs:
- Hepatotoxicity: Beta-lactams (5%-17%), quinolones (3%)
- Cytopenias: Linezolid (5%), beta-lactams (6%)
- Nausea: Rifampicin
- Renal failure: Cotrimoxazole
- Skin rash: Rare, commonly associated with penicillins or cotrimoxazole
- Costs: AEs from prolonged antibiotic use lead to longer hospitalization, additional monitoring care, and additional investigations
- Prevention: Keep antibiotic treatment duration short and use the lowest clinically necessary dose
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