Antibiotic duration and type associated with chronic post-amputation pain in military cohort
Photo by David Trinks / Unsplash
Key Takeaway
Consider antibiotic duration and type as potential risk factors for chronic pain in amputees, but recognize this is observational evidence.
This retrospective cohort study examined associations between antibiotic use and chronic post-amputation pain in 212 military personnel with traumatic amputations. The analysis focused on antibiotic duration, type, and combination regimens, though specific comparators were not reported. Among the cohort, 94 patients (44%) developed chronic residual limb pain or phantom limb pain. Prolonged antibiotic use exceeding 21 days and combined regimens of 2 or more antibiotics were associated with increased risk of chronic post-amputation pain. Neuropathic pain was reported as predominant in patients exposed to fluoroquinolones or metronidazole. No safety, tolerability, or adverse event data were reported in the study. Key limitations include the retrospective observational design, which cannot establish causation, and the lack of reported effect sizes, confidence intervals, or p-values for the associations. The study population was specific to military personnel with traumatic amputations, limiting generalizability. The authors suggest personalized antimicrobial stewardship and early pain screening may be relevant for this high-risk population, but these recommendations are based on associative findings rather than causal evidence.
More on Chronic Pain
Meta-analysis: Postoperative oral antibiotics reduce cellulitis after cesarean in obese women
Adding two antibiotics may lower cellulitis risk for obese women having C-sections
This systematic review and meta-analysis of 1144 obese women undergoing cesarean delivery found that adding postoperative oral cephalexin an…
A large review found adding oral cephalexin and metronidazole to standard care significantly reduced cellulitis in obese women after C-secti…
FDA Approves Metronidazole Injection for Anaerobic Infections and Prophylaxis
FDA approves new antibiotic for serious anaerobic bacterial infections
The FDA approved Metronidazole Injection for treatment of serious anaerobic infections and for prophylaxis in elective colorectal surgery. I…
The FDA approved Metronidazole Injection USP for serious infections caused by anaerobic bacteria. It treats conditions like abdominal, skin,…
Retrospective study compares antibiotic regimens for H. pylori eradication in children.
Two antibiotic regimens cleared H. pylori in most children within four weeks.
This retrospective observational study evaluated two antibiotic combinations for treating Helicobacter pylori infection in children aged 4 t…
A look at two common treatments found that both regimens successfully eliminated the bacteria in most children within four weeks.
Meta-analysis finds rTMS improves neuropathic pain in spinal cord injury patients.
rTMS may ease nerve pain after spinal cord injury, but not anxiety or depression
This meta-analysis of 7 RCTs with 159 patients found repetitive transcranial magnetic stimulation (rTMS) significantly improved neuropathic …
A review of seven trials found that repetitive magnetic stimulation reduced neuropathic pain in spinal cord injury patients, but did not sig…
View Original Abstract ↓
BackgroundAntibiotic (AB) therapy is standard in managing combat-related infections, particularly after traumatic limb amputations. However, prolonged or combined antibiotic regimens may contribute to neuroinflammatory processes that predispose patients to chronic post-amputation pain (ChPAP), which combines the consepts of chronic residual limb pain (RLP) and phantom limb pain (PLP).ObjectiveTo investigate associations between antibiotic use (duration, type, and combination) and the development of RLP and PLP in post-amputation military patients.MethodsThis retrospective cohort study evaluated 212 military personnel treated between 2022 and 2024 for traumatic amputations. Antibiotic regimens, pain intensity, type, and chronicity were analyzed.ResultsChronic RLP/PLP developed in 94 patients (44.3%). Prolonged antibiotic use (>21 days) and combined regimens (≥2 antibiotics) were) were related with increased ChPAP risk in limbs Neuropathic pain was predominant in patients exposed to fluoroquinolones or metronidazole.ConclusionExtended and multi-agent antibiotic therapy was associated with ChPAP after combat-related limb amputation. Personalized antimicrobial stewardship and early pain screening are recommended in this high-risk population.
Electroacupuncture with Pelvic Floor Training Reduces Stress Urinary Incontinence Leakage
Two Treatments Beat Surgery for Leaky Bladders
Related in Anesthesiology & Pain Medicine
Kinesio Taping Plus Stretching Improves Pain and Function in Carpal Tunnel Syndrome
Home taping beats electrical stimulation for wrist pain and grip strength in adults
This randomized controlled trial in 42 adults with carpal tunnel syndrome compared home-based Kinesio taping plus myofascial stretching to T…
A home-based taping method combined with stretching improved wrist pain and grip strength more than electrical stimulation in adults with ca…
Narrative review discusses link between diamine oxidase deficiency and fibromyalgia pathophysiology
DAO supplementation may reduce fibromyalgia pain and impact
This narrative review examines the relationship between histamine intolerance, diamine oxidase (DAO) deficiency, and fibromyalgia. The autho…
New evidence suggests that addressing diamine oxidase deficiency could help reduce pain and improve daily life for some people with fibromya…
Narrative review identifies determinants of susceptibility to digital health misinformation
What makes people fall for health misinformation online?
This narrative review examines the determinants of susceptibility to digital health misinformation across individual, relational, and platfo…
Low health literacy and emotional reasoning make people more vulnerable to digital health misinformation, a new review finds.
Acupuncture and Celecoxib for Chronic Knee Pain: Genetic Factors May Influence Response
New Gene Test Predicts Who Gets Pain Relief From Acupuncture
This randomized trial compared verum acupuncture, sham acupuncture, celecoxib, placebo, and waiting list in 180 patients with chronic knee p…
A new gene test might help doctors know if acupuncture will actually stop your knee pain before you start treatment.
From Other Specialties
Therapeutic Touch Reduces Crying and Improves Sleep in Infants With Colic
Therapeutic touch reduces crying in babies with colic
This randomized controlled trial in 96 infants with colic found that therapeutic touch based on Watson's Human Care Theory significantly red…
A new trial shows gentle therapeutic touch helps babies cry less and sleep better when they have infantile colic.
Mycophenolate mofetil non-inferior to prednisone for first-episode nephrotic syndrome in children
Mycophenolate Mofetil Offers Alternative to Steroids for Nephrotic Syndrome
This phase 3 non-inferiority trial randomized 272 children aged 1-10 years with first-episode steroid-sensitive nephrotic syndrome to mycoph…
A new trial shows mycophenolate mofetil works as well as prednisone for children with nephrotic syndrome, with fewer steroid side effects.
AquOTic water competency intervention improves outcomes in children with autism
Water therapy improves skills for children with autism spectrum disorder
This pre-post cohort study of 37 children with autism ages 5 to 9 found that a 10-week occupational therapy-based water competency intervent…
A water-based occupational therapy program significantly improved performance and satisfaction scores in children with autism spectrum disor…
Play-based cognitive flexibility training boosts creativity in third graders
Playful workshops boost story skills and flexible thinking for third graders
This RCT in 249 third graders found that a 14-session play-based workshop significantly improved narrative creativity and cognitive flexibil…
A fun 14-session workshop helped third graders write better stories and think more flexibly than peers in regular classes.