Prevention and Treatment of Frostbite Infection with Antimicrobial Pharmacokinetic Analysis
Abstract
Cold injury, such as frostbite, can lead to devastating consequences that affect both civilians and Service Members. Much research is dedicated to how to treat frostbite in the first 24 hours, like warming the affected area in water, and using special medications to thin the blood (frostbite damages capillaries and prevents adequate blood flow to the tissues). Unfortunately, despite these treatments, most patients develop wounds that need daily care, and some will need amputations. These wounds take weeks to heal increasing the chance of infections. Aloe vera has historically been used to treat frostbite wounds, based on early work on rabbit ears. However, there are few studies examining the effects of aloe on frostbitten humans, and even fewer studies examining how different dressings can prevent infections (prophylaxis) or how we can treat those infections. Finally, little is known about how antibiotics penetrate frostbitten tissues and whether patients with frostbite process/metabolize these antibiotics as expected. This work addresses the FY22 DMRDP BWMIR Focus Area to understand appropriate wound prophylaxis/empiric treatment strategies for frostbite wounds throughout the continuum of care including the evaluation of antimicrobial dosing and tissue penetration studies to inform clinical practice guidelines. We propose a study examining three aims. First, we will study the effect of long-acting silver dressings versus aloe vera on frostbite wounds and compare rates of infections/growth of bacteria. Silver dressings can be applied with minimal training and left in place for days, decreasing the need for multiple painful daily dressing changes, and easing logistical pressures. Second, we will study the effectiveness and tissue penetration of a long-acting antibiotic, dalbavancin. This antibiotic is given once a week, and we will examine its effectiveness in treating frostbite wound infection. This antibiotic also significantly reduces resources required by eliminating the need for repeated daily doses. Finally, we will examine if frostbite patients exhibit alerted kidney function, as often seen in trauma and burn patients. If present, then antibiotic dosages will be adjusted to better treat infections. We project a timeline of 3 years to complete this work. This will benefit both military and civilian frostbite patients by giving medical providers more options in how to treat frostbite, decreasing pain by decreasing dressing changes, and lead to better prevention and treatment of infections. This research will lead the way to developing improved frostbite wound care dressings and antibiotic therapies in complex wounds.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252311053
Entities
People
- Arek Wiktor
Organizations
- United States Army
- University of Colorado Denver