Progression of Infected Diabetic Foot Ulcers to Amputation Cases; A Comparative Study of Meropenem vs Linezolid Treatments

Objective: To study the effectiveness of Linezolid in comparison to Meropenem for diabetic foot disease in terms of decreasing the number of amputations and infection clearance. Study Design: Quasi Experimental Study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2020 to Apr 2021. Methodology: A total of 188 patients suffering from diabetic foot disease who met the inclusion criteria were included. Patients were divided into two Groups, Group A received Linezolid while Group B received Meropenem at standard doses. Patients were evaluated after 10 days of antibiotic therapy. All patients received testing for pre- and post-treatment C-reactive protein levels and progression to amputation within 6 months which were checked across both Groups for improvement as an indicator of treatment effectiveness. Data was analyzed by SPSS 26.0. Results: The mean C-reactive protein level on enrollment for Group A was 84.71±27.29 mg/L, while the same was 83.33±26.74 mg/L in Group B (p=0.73). These levels were 6.84±5.5 mg/L and 8.94±8.73 in Groups A and B, respectively, post-treatment (p=0.049). Treatment was declared successful in 84(89.4 %) with Linezolid, while in 72(76.6%) on Meropenem (p=0.02). A total of 6(6.4%) patients underwent amputation at 6 months in the Linezolid Group versus 2(2.1%) in the Meropenem Group, p=0.14. Conclusion: Linezolid is an effective drug for which can be used in the management of diabetic foot disease with different clinical manifestations. It demonstrates superiority to Meropenem in terms of clearance of infection and progression to amputation.