Intra-Arterial Treatment of Stage IV Arterial Occlusive Disease with Ceftizoxime

In conjunction with methods of improving blood flow and local surgical measures, antibacterial therapy is an essential component of the management of infected ischaemic lesions. Concentrations of active drug at the site of infection can be increased by intra-arterial administration, which produces higher tissue levels than intravenous administration. 35 patients with polyinfected ischaemic lesions were given ceftizoxime 2g once daily by intra-arterial infusion, with an additional 2 g/day by intravenous infusion, to maintain adequate concentrations of the drug over 24 hours. After an average treatment period of 9.2 days, infection was controlled in 25 patients (71%), and a further 6 patients whose infection did not improve satisfactorily subsequently underwent successful vascular reconstruction. Limb preservation was therefore achieved in a total of 31 patients (88%). There were no signs of local intolerance.