Literature Study of Pharmacokinetic Profile and Penetration of Antibiotics into Diabetic Ulcer Tissue
Keywords:diabetic ulcers, Pharmacokinetics, PICO
A diabetic foot ulcer is a complication of diabetes that causes open sores that can develop into an infection. The selection of the right antibiotics is based on the pharmacokinetic profile of antibiotics that can show antibiotic activity as bactericidal or bacteriostatic, the main bacteria found in diabetic ulcer disease are gram-positive bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSa). This study aims to determine the antibiotics acting on diabetic ulcer tissue and the pharmacokinetic profile and penetration of antibiotics into diabetic ulcer tissue based on a literature study using the PICO (patient/population, intervention, comparison, and outcomes) method. The results of the analysis of 8 articles that met the inclusion criteria showed that the pharmacokinetic profile (PK) of several antibiotics obtained showed bactericidal activity in the treatment of diabetic ulcers including the antibiotics ceftolozane/tazobactam, tedizolid, cefepime, daptomycin, trimethoprim/sulfamethoxazole. Several antibiotics have shown activity as bacteriostatic in the treatment of diabetic ulcers, including linezolid antibiotics and vancomycin antibiotics.
Hamada, Y., Kuti, J. L., & Nicolau, D. P. (2016). Vancomycin serum concentrations do not adequately predict tissue exposure in diabetic patients with mild to moderate limb infections. Journal of Antimicrobial Chemotherapy, 70(7), 2064–2067. https://doi.org/10.1093/jac/dkv074
Hutagalung, M. B. Z., Eljatin, D. S., Awalita, Sarie, V. P., Sianturi, G. D. A., & Santika, G. F. (2019). Diabetic Foot Infection (Infeksi Kaki Diabetik): Diagnosis dan Tatalaksana. Continuing Medical Education, 46(6), 414–418.
Ibrahim, A. M. (2019). Diabetic Foot Ulcer : Synopsis of the Epidemiology and Pathophysiology Diabetic Foot Ulcer : Synopsis of the Epidemiology and Pathophysiology. April. https://doi.org/10.11648/j.ijde.20180302.11
Komite PPRA. (2016). Panduan Umun Penggunaan Antimikroba. 1–15.
McBride, D., Krekel, T., Hsueh, K., & Durkin, M. J. (2017). Pharmacokinetic drug evaluation of tedizolid for the treatment of skin infections. Expert Opinion on Drug Metabolism and Toxicology, 13(3), 331–337. https://doi.org/10.1080/17425255.2017.1290080
Minichmayr, I. K., Schaeftlein, A., Kuti, J. L., Zeitlinger, M., & Kloft, C. (2017). Clinical Determinants of Target Non-Attainment of Linezolid in Plasma and Interstitial Space Fluid: A Pooled Population Pharmacokinetic Analysis with Focus on Critically Ill Patients. Clinical Pharmacokinetics, 56(6), 617–633. https://doi.org/10.1007/s40262-016-0463-7
Monogue, M. L., Stainton, S. M., Baummer-Carr, A., Shepard, A. K., Nugent, J. F., Kuti, J. L., & Nicolau, D. P. (2017a). Pharmacokinetics and tissue penetration of ceftolozane-tazobactam in diabetic patients with lower limb infections and healthy adult volunteers. Antimicrobial Agents and Chemotherapy, 61(12), 1–28. https://doi.org/10.1128/AAC.01449-17
Monogue, M. L., Stainton, S. M., Baummer-Carr, A., Shepard, A. K., Nugent, J. F., Kuti, J. L., & Nicolau, D. P. (2017b). Pharmacokinetics and tissue penetration of ceftolozane-tazobactam in diabetic patients with lower limb infections and healthy adult volunteers. Antimicrobial Agents and Chemotherapy, 61(12), 1–10. https://doi.org/10.1128/AAC.01449-17
Pea, F. (2016). Practical concept of pharmacokinetics/pharmacodynamics in the management of skin and soft tissue infections. Current Opinion in Infectious Diseases, 29(2), 153–159. https://doi.org/10.1097/QCO.0000000000000256
Ratnasari, P. (2016). Studi penggunaan Antibiotik Pada Pasien Diabetik Foot Ulcer (Penelitian di IRJ Poli Bedah RSUD Dr. Soetomo Surabaya). http://repository.unair.ac.id/55104/
Sari, Y. O., Almasdy, D., & Fatimah, A. (2018). Evaluasi Penggunaan Antibiotik Pada Pasien Ulkus Diabetikum di Instalasi Rawat Inap (IRNA) Penyakit Dalam RSUP Dr. M. Djamil Padang. Jurnal Sains Farmasi & Klinis, 5(2), 102. https://doi.org/10.25077/jsfk.5.2.102-111.2018
So, W., Kuti, J. L., Shepard, A., Nugent, J., & Nicolau, D. P. (2016). Tissue penetration and exposure of cefepime in patients with diabetic foot infections. International Journal of Antimicrobial Agents, 1–2. https://doi.org/10.1016/j.ijantimicag.2016.01.002
Stainton, S. M. (2017). Comparative Assessment of Tedizolid Pharmacokinetics and Tissue Penetration Between Diabetic Patients with Wound Infections and Healthy Volunteers via In Vivo Microdialys. October. https://doi.org/10.1128/AAC.01880-17
Stainton, S. M., Monogue, M. L., Baummer-Carr, A., Shepard, A. K., Nugent, J. F., Kuti, J. L., & Nicolau, D. P. (2018). Comparative assessment of tedizolid pharmacokinetics and tissue penetration between diabetic patients with wound infections and healthy volunteers via in vivo microdialysis. Antimicrobial Agents and Chemotherapy, 62(1), 1–8. https://doi.org/10.1128/AAC.01880-17
Stein, G. E., Schooley, S., Peloquin, C. A., Missavage, A., & Havlichek, D. H. (2016). Linezolid tissue penetration and serum activity against strains of methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility in diabetic patients with foot infections. Journal of Antimicrobial Chemotherapy, 60(4), 819–823. https://doi.org/10.1093/jac/dkm271
Stein, G. E., Throckmorton, J. K., Scharmen, A. E., Weiss, W. J., Prokai, L., Smith, C. L., & Havlichek, D. H. (2016). Tissue penetration and antimicrobial activity of standard- and high-dose trimethoprim/sulfamethoxazole and linezolid in patients with diabetic foot infection. Journal of Antimicrobial Chemotherapy, 68(12), 2852–2858. https://doi.org/10.1093/jac/dkt267
Thabit, A. K., Fatani, D. F., Bamakhrama, M. S., Barnawi, O. A., Basudan, L. O., & Alhejaili, S. F. (2019). Antibiotic penetration into bone and joints: An updated review. International Journal of Infectious Diseases, 81, 128–136. https://doi.org/10.1016/j.ijid.2019.02.005
Traunmüller, F., Schintler, M. V., Metzler, J., Spendel, S., Mauric, O., Popovic, M., Konz, K. H., Scharnagl, E., & Joukhadar, C. (2016). Soft tissue and bone penetration abilities of daptomycin in diabetic patients with bacterial foot infections. Journal of Antimicrobial Chemotherapy, 65(6), 1252–1257. https://doi.org/10.1093/jac/dkq109
Yusuf, S., & Syam, Y. (2018). Berdasarkan Lama Menderita Luka. Jurnal Kesehatan Manarang, 4(2), 87–92.
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