What is it about?
Necrotising fascitis (NF) is a rapidly progressive severe soft tissue infection of the deep fascia resulting in destruction of overlying subcutaneous tissue and skin. We report the case of NF of lower limb with poor prognosis due to multidrug resistant (MDR) Klebsiella pneumoniae(K.pneumoniae) sensitive only to colistin. In view of worsening condition of the wound, risk of deterioration of renal function and economic constraints, it was decided to start on colistin therapy locally by colistimethate sodium (CMS). Patient responded well to the treatment and got clinically better. Subsequent culture sent post treatment showed no growth of the organism. Wound healed with regular dressings by 8 weeks. This was found to be a very cost effective treatment modality. Local use of CMS was found to be a novel method of achieving infection free wound especially against MDR K.pneumoniae
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Why is it important?
More effective and economic alternative in severely compromised individuals having infected wounds due to necrotising fascitis
Perspectives
This was a patient with necrotising fascitis with spesis and renal issues with economic constraints. Culture grew multidrug resistant k.pneumoniae resistant to all drugs except colistin which was expensive.we successfully treated it in a novel way using local application of colistin mixed with debridace oint
Dr Riju R Menon
Amrita Vishwa Vidyapeetham
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This page is a summary of: Efficacy of colistimethate sodium as local application in necrotising fasciitis, BMJ Case Reports, November 2019, BMJ,
DOI: 10.1136/bcr-2019-232354.
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