Cross-sectional, Observational Study to Assess Clinical Role of Oral and Injectable Linezolid in Post-operative Diabetic Foot Ulcers: COOLD Study

ABSTRACT

Background: Diabetic foot ulcers (DFUs) remain difficult to treat with likely incriminating risk factors involving Methicillinresistant Staphylococcus aureus (MRSA). Linezolid offers complimentary consistent action against MSSA and MRSApathogens making it an ideal choice for inpatient, switch or outpatient therapy for complicated skin and skin structureinfections.Objective: The objective of the study was to compare the efficacy of injectable versus oral linezolid in the management ofpost-operative DFUs.Materials and Methods: Retrospective analyses of 100 cases receiving oral or injectable linezolid. A total of 100 subjectswere enrolled in this study. Two groups were made of 50 patients each and labeled as Group A and Group B. In Group A,tablet linezolid was given in a dose of 600 mg BD for 7 days. In Group B, injectable linezolid was given in a dose of 600 mgintravenous (IV) BD for 7 days. Clinical and bacteriological improvement was documented. In both groups tablet cefuroxime,500 mg BD was given for 7 days in conjunction with linezolid.Results: We found 90–100% improvement in wound infections and in culture reports. Results in both the groups receivingoral or IV linezolid for post-operative DFU healing were comparable when administered for 7 days. Linezolid offered hightherapeutic success rates (75–100%) against the incriminated pathogens of S. aureus with little action against Acinetobacteror Pseudomonas aeruginosa.Conclusion: These results suggest that linezolid given empirically is highly effective in the treatment of DFUs. The equivocalclinical and microbiological eradication rates for oral and injectable formulations with 7 days therapy makes them less liable forresistance induction or development.