Sequential intravenous/oral moxifloxacin versus intravenous piperacillin-tazobactam followed by oral amoxicillin-clavulanate for the treatment of complicated skin and skin structure infection

Giordano, Philip; Song, James; Pertel, Peter; Herrington, Janet; Kowalsky, Steven F.

doi:10.1016/j.ijantimicag.2005.07.017

Cited by 65 publications

(64 citation statements)

References 30 publications

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“…Clinical studies investigating the efficiency of systemically delivered moxifloxacin for the treatment of skin or soft tissue infections demonstrated clinical cure rates between 79 and 90% (10,21). Therefore, the daily dose for a systemic application of moxifloxacin added up to 400 mg, while the final amount of moxifloxacin used in our study was only 0.5 mg per wound per day, which aggregates to a maximum load of 2 mg moxifloxacin per animal and day.…”

Section: Discussionmentioning

confidence: 83%

Efficacy of Topically Delivered Moxifloxacin against Wound Infection by Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus

Jacobsen

Fisahn

Sorkin

et al. 2011

Antimicrob Agents Chemother

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Wound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 10 5 CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing.

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Section: Discussionmentioning

confidence: 83%

Efficacy of Topically Delivered Moxifloxacin against Wound Infection by Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus

Jacobsen

Fisahn

Sorkin

et al. 2011

Antimicrob Agents Chemother

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“…Diabetic foot infections were prospectively characterized for severity according to the modified Wagner classification [15]. Clinical signs and symptoms of cSSSI were evaluated prior to therapy, during treatment (days 1-3), on the day of switch from po to iv therapy, at test-of-cure (TOC; days [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], and at any additional on-treatment visits. Only the TOC data are presented in this paper.…”

Section: Clinical and Bacteriological Assessmentsmentioning

confidence: 99%

Efficacy and safety of sequential intravenous/oral moxifloxacin vs intravenous/oral amoxicillin/clavulanate for complicated skin and skin structure infections

et al. 2009

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“…In this study, 21 where the authors noted that surgery rarely resulted in the total resection of all infected tissue, antibiotic treatment is likely necessary after amputation. [22][23][24][25][26][27][28][29][30] Of these, 9 randomized clinical trials that focus on antimicrobial treatment of DFI were identified (see Table 2). Of the 4 studies that included patients who received amputations, 1 study eliminated patients who received amputations from the clinical response endpoint and were deemed endpoint failures.…”

Section: Commentmentioning

confidence: 99%

How long to treat with antibiotics following amputation in patients with diabetic foot infections? Are the 2012 IDSA DFI guidelines reasonable?

2013

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Summary What is known and Objective To the best of our knowledge, there has been no published study designed to identify the most appropriate duration of antibiotic therapy in lower extremity skin and skin structure infections in diabetic patients [aka “diabetic foot infections” (DFI)] post‐amputation. However, recent guidelines published by the Infectious Diseases Society of America (IDSA) provide recommendations for treatment duration in these patients. Therefore, our objective is to review the literature evaluating antibiotic treatment in DFI to determine if the IDSA guidelines are reasonable. Comment Evidence for the use of antibiotics after amputation comes largely from perioperative surgical prophylaxis studies evaluating the rate of infection after amputation. Three such studies were identified; 2 found a 5‐day course of antibiotics post‐amputation resulted in a reduction of infection rate, while 1 found no additional benefit. Comparative antibiotic studies in DFI also offers evidence for treatment duration, of which, 10 studies were identified. Five included patients who received amputations; however, only 1 reported treatment outcomes in a subset of diabetics requiring amputation. In this study, the authors concluded that antibiotic treatment is likely necessary after amputation. What is new and Conclusion Given the general lack of data, we recommend that post‐operative treatment duration be individualized, and, until further studies are done, it seems reasonable to adhere to the recommendation provided by the 2012 IDSA DFI guidelines for a 2–5 day course of antibiotic therapy post‐operatively when no residual infected tissue remains.

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Sequential intravenous/oral moxifloxacin versus intravenous piperacillin-tazobactam followed by oral amoxicillin-clavulanate for the treatment of complicated skin and skin structure infection

Cited by 65 publications

References 30 publications

Efficacy of Topically Delivered Moxifloxacin against Wound Infection by Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus

Efficacy of Topically Delivered Moxifloxacin against Wound Infection by Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus

Efficacy and safety of sequential intravenous/oral moxifloxacin vs intravenous/oral amoxicillin/clavulanate for complicated skin and skin structure infections

How long to treat with antibiotics following amputation in patients with diabetic foot infections? Are the 2012 IDSA DFI guidelines reasonable?

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