Metisilin dirençli Staphylococcus aureus'un etken olduğu diyabetik ayak enfeksiyonlarında teikoplaninin etkinliği

Diyabetik ayak lezyonlarında en sık etken olan mikroorganizmalar Staphylococcus aureus, koagülaz negatif stafilokoklar ve grup B streptokok gibi Gram pozitif bakterilerdir. Bu çalışmada, 2005-2006 yıllarında yatarak tedavi edilen ve kültürlerinde metisiline dirençli S.aureus (MRSA) üremesi saptanan 29 diyabetik ayak infeksiyonunda teikoplaninin etkinliği incelenmiştir. Üç-altı haftaya tamamlanan tedavi süresince bir hasta (% 3) gelişen yan etki nedeniyle çalışmadan çıkarılmıştır. Yirmisekiz hastanın 25’inde (% 89) klinik şifa ve düzelme saptanırken, üç hastada (% 11) ondördüncü günde MRSA üremesi devam etmiştir. Sonuç olarak, teikoplaninin, MRSA suşlarının etken olduğu diyabetik ayak infeksiyonlarının tedavisinde iyi bir seçenek olduğu görülmüştür. Teikoplaninin özellikle tek doz, intramüsküler ve ayaktan parenteral tedavi koşullarında uygulanabilir olması, diyabetik ayak gibi uzun tedavi seçeneklerini kolay uygulanabilir ve ekonomik kılmaktadır.

Anahtar Kelimeler:

Diabetik ayak, Metsilin-dirençli Staphylococcus aureus, Mikrobiyal duyarlılık testleri, İleriye dönük çalışma, Teikoplanin

Efficacy of teicoplanin in diabetic foot infections caused by methicillin resistant Staphylococcus aureus

The most commonly isolated pathogens as infection agents in diabetic foot patients are Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative staphylococci and group B streptococci. The aim of this study is to evaluate the efficacy of teicoplanin in 29 diabetic foot infections caused by methicillin resistant S.aureus (MRSA). Only one patient was ex-cluded because of side effects after 3-6 weeks of therapy. Clinical and laboratory cure was established in twenty-five out of 28 (89 %) patients, whereas culture positivity of MRSA was continued in 3 (11 %) patients after 14 day of therapy. As a conclusion, teicoplanin was found to be an appropriate choice in treatment of diabetic foot infections caused by MRSA. Pharmacoeconomic considerations of teicoplanin like its long half-life, intramuscular and/or intravenous administration routes and acceptibility of outpatient parenteral therapy made the drug more compliable and economic especially in those infections with prolonged hospital stay as diabetic foot infections.

Keywords:

Diabetic Foot, Methicillin-Resistant Staphylococcus aureus, Microbial Sensitivity Tests, Prospective Studies, Teicoplanin,

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