Antibiotic Consumption and Bloodstream Infections in Patients With Chronic-limb Threatening Ischemia Following Endovascular Therapy in East-west Germany, 2019–2020.

This article examines the increased risk of systemic infections, specifically bloodstream infections (BSI), in patients with chronic-limb threatening ischemia (CLTI), the most advanced form of peripheral artery obstructive disease (PAOD), compared to PAOD patients without CLTI. Using administrative data from the German statutory health insurance AOK Baden-Wuerttemberg, the study found that CLTI patients (Rutherford-Becker categories 5 and 6) had a 3.9-fold higher risk of BSI and a 5.6-fold higher risk of Staphylococcus aureus BSI than those with less severe PAOD (RBC 1-4). Infection-related causes accounted for 7.7% of 30-day hospital readmissions following endovascular treatment (EVT) in CLTI patients. The study also identified that outpatient antibiotic prescriptions for infected ischemic ulcers frequently included aminopenicillins with β-lactamase inhibitors, clindamycin, and cefuroxime, with concerns raised about the appropriateness of clindamycin and cefuroxime use. These findings highlight the need for optimized antibiotic therapy and a comprehensive, interdisciplinary approach to managing infections in CLTI patients.