Efficacy of colistimethate sodium as local application in necrotising fasciitis

Murali, Sreedutt; Pillai, Anjali; Ramachandran, Riju

doi:10.1136/bcr-2019-232354

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…Despite detailed instructions to maintain wound hygiene, the patient developed postoperative infection with Acinetobacter baumanii, sensitive to colistin and tigecycline. Local application of colistin instead of systemic administration, in susceptible infections, prevents renal toxicity and reduces the treatment cost [16]. In our case also, the infection was successfully controlled with local application of colistimethate sodium; however, the wound healed with scarring of lid margin.…”

Section: Discussionmentioning

confidence: 58%

Challenges in the Management of Upper Lid Keloid

Goel

Khanam

Shah

et al. 2022

Case Reports in Ophthalmological Medicine

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A middle-aged lady presented with a firm, nontender mass on the left upper lid and area behind the left ear following lid reconstruction with postauricular graft for cicatricial ectropion 11 months prior. She had a similar mass on the right shin. She was diagnosed as a case of multiple keloids. Intralesional injection of triamcinolone acetonide suspension and 5-Fluorouracil (5-FU) in the upper lid keloid resulted in ulceration of its surface. Surgical excision, injection of 5-FU in the keloid bed with temporal forehead flap reconstruction, was performed. Occurrence of inadvertent postoperative wound infection with Acinetobacter baumannii was treated with local dressing with colistimethate sodium. Adjuvant therapy with topical imiquimod cream 5% was given subsequently for 24 weeks with no recurrence of the lid keloid after 16 months. The patient was managed using a combination of conservative and surgical therapy and multidisciplinary team work and kept on a long term follow-up.

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Section: Discussionmentioning

confidence: 58%

Challenges in the Management of Upper Lid Keloid

Goel

Khanam

Shah

et al. 2022

Case Reports in Ophthalmological Medicine

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“… 16 Also, there are reports of local application of colistin giving good results in MDR Klebsiella . 17 Hence, NPWTi with colistin instillation was considered for this patient. With three sittings of NPWTi, the wound granulated very well and the inflammation subsided.…”

Section: Discussionmentioning

confidence: 99%

Axillary artery thrombosis resulting in upper limb amputation as a COVID-19 sequela

et al. 2021

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Novel COVID-19 continues to intrigue medical professionals with its varied presentations. Though it affects the respiratory tract primarily, thrombogenesis has been the Achilles’ heel. A 44-year-old man diagnosed with COVID-19 presented with upper limb pain at a local hospital and was found to have thrombosis of the right axillary artery. Despite a successful embolectomy at the local hospital, there was re-occlusion of the axillary artery and the limb became ischaemic. He was referred to our institution by which time the limb became gangrenous above the elbow and had to be amputated. Extensive sloughing of the nerves was also seen in the local area. Hypercoagulability presenting with various manifestations is common in COVID-19 and needs early anticoagulation. We present this asymptomatic patient who lost a limb to this COVID-19 sequelae.

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“…There are only anecdotical reports on the use of topical antibiotics in NSTIs [119], as was suggested in necrotic pancreatitis [120]. Although their added benefit to parenteral treatment and surgery was not investigated, this approach does not seem suited as an exclusive first-line therapy.…”

Section: Available Data On Antibiotic Diffusion In the Presence Of Altered Perfusionmentioning

confidence: 99%

Antibiotics in Necrotizing Soft Tissue Infections

et al. 2021

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Necrotizing soft tissue infections (NSTIs) are rare life-threatening bacterial infections characterized by an extensive necrosis of skin and subcutaneous tissues. Initial urgent management of NSTIs relies on broad-spectrum antibiotic therapy, rapid surgical debridement of all infected tissues and, when present, treatment of associated organ failures in the intensive care unit. Antibiotic therapy for NSTI patients faces several challenges and should (1) carry broad-spectrum activity against gram-positive and gram-negative pathogens because of frequent polymicrobial infections, considering extended coverage for multidrug resistance in selected cases. In practice, a broad-spectrum beta-lactam antibiotic (e.g., piperacillin-tazobactam) is the mainstay of empirical therapy; (2) decrease toxin production, typically using a clindamycin combination, mainly in proven or suspected group A streptococcus infections; and (3) achieve the best possible tissue diffusion with regards to impaired regional perfusion, tissue necrosis, and pharmacokinetic and pharmacodynamic alterations. The best duration of antibiotic treatment has not been well established and is generally comprised between 7 and 15 days. This article reviews the currently available knowledge regarding antibiotic use in NSTIs.

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Efficacy of colistimethate sodium as local application in necrotising fasciitis

Cited by 5 publications

References 8 publications

Challenges in the Management of Upper Lid Keloid

Challenges in the Management of Upper Lid Keloid

Axillary artery thrombosis resulting in upper limb amputation as a COVID-19 sequela

Antibiotics in Necrotizing Soft Tissue Infections

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