Lower Extremity Infection

Dalbavancin & Oritavancin – PART 2

November 17, 2014

In my post last week I mentioned I would write a follow up to discuss my opinions on the use of these drugs for lower extremity infections.  I have not yet had the opportunity to try either so these are really “top line” thoughts taken what I know, have read or heard from others, into consideration. – These drugs are expensive and I wonder who will cover the cost.

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New Antibiotics – Dalbavancin & Oritavancin PART 1

November 10, 2014

In this entry I will continue to explore some of the new antibiotics that have been recently approved for use in acute bacterial skin and skin structure infections (ABSSSI). I will discuss these two together since they are quite similar in a number of important ways and share many of the same properties. Both dalbavancin (Dalvance™ – Actavis) and oritavancin (Orbactive™ – The Medicines Company) are classified as “semisynthetic lipoglycopeptide” antibiotics

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ONYCHOMYCOSIS – What Are We Teaching?

November 3, 2014

I have been doing LOTS of talks on onychomycosis over the past few months. The vast majority of these have been CME lectures where I spend significantly more time reviewing the background information of onycho than talking about new drug therapies.  What has amazed me since I first started speaking on this topic over 25 years ago is the lack of understanding of the science behind this INFECTION.  Yes, you read that correctly…onychomycosis is an INFECTION and should be treated with anti-INFECTIVES.  We don’t think twice about treating a bacterial infection with an antibiotic, why don’t we feel as strongly about treating a fungal infection with an antifungal?  This has been my introductory statement in every lecture I give about this disease since I first became interested in this topic and my feeling has not waivered about it.

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New Antibiotics – Tedizolid

October 23, 2014

As I mentioned in my previous post, this has been a pretty exciting time in the area of lower extremity infectious diseases. Not only do we have 2 new drugs for onychomycosis (to be covered in future posts) but we also have 3 new FDA approved antibiotics for the treatment of, in FDA Speak; “acute bacterial skin and skin structure infections” (aBSSSI).  These drugs are tedizolid, dalbavancin and oritavancin.  Of these, the one that I am most interested in, at least at this moment, is tedizolid.

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Antibiotics And DFIs: What The Evidence Reveals

February 24, 2014

Given the prevalence of foot infections in patients with diabetes, aggressive and judicious management with antibiotics is crucial.

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‘Skin popping’ of the foot by drug abusers

February 22, 2014

Demographic description of the presentation and treatment of lower extremity skin and soft tissue infections secondary to skin popping in intravenous drug abusers. Pirozzi K1, Van JC1, Pontious J2, Meyr AJ3. J Foot Ankle Surg

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Partial Foot Amputations for Salvage of the Diabetic Lower Extremity

January 1, 2014

Lower extremity infections are a common yet unfortunate complication of diabetes-related ulcers often requiring surgical intervention. The main goals of surgical treatment consist of selecting the appropriate procedure to effectively eradicate nonsalvageable tissue, achieve primary healing, and maximize subsequent dynamic functionality. An overview of each partial foot amputation procedure is discussed with a focus on procedure selection as well as standard and advanced surgical techniques.

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News Story About Pharma Industry Payments – Response

March 13, 2013

I am sorry that it has been so long since I put up a post.  Things have been slightly hectic. Unfortunately, instead of reporting on new infectious disease information, with this entry I find myself responding to a story about my receiving payments to lecture from the pharmaceutical industry.  The story ran today (3/13/13) in the Philadelphia Inquirer and online at www.philly.com .  http://www.philly.com/philly/health/20130312_Philly_foot_doc_among_highest_paid_by_Big_Pharma.html When the original print story was run I had not had a chance to respond to the author, reporter Sam Woods.  I give Mr. Woods credit for updating the online story in response to some of my comments, reproduced below, which I emailed to him this morning.   I feel that the Pharma Industry has done an excellent job in disseminating important information that may otherwise not be available to those of us interested in saving limbs of patients with diabetes.  This is done in an unbiased, government approved and monitored way, under strict federal guidance.  My lectures are randomly, and independently audited for compliance with these guidelines and I have never been found to be deficient.  Here is my response to Mr

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Can Bracing Have An Impact For The Charcot Foot?

February 27, 2013

Although surgical reconstruction can be effective for patients with Charcot, not every patient is an appropriate candidate for surgery. Accordingly, this author explores the potential of employing various forms of bracing, including ankle foot orthoses and patellar tendon bracing, in patients with Charcot foot. read more

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Off-Label Drug Promotion: Coming Soon?

December 18, 2012

The U.S. Second Circuit Court of Appeals recently ruled to prohibit criminal prosecution for truthful off-label promotion of drugs as a First Amendment right

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