JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields.

eISSN: 2980-0862
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Original Article
Relationship between wound fluid antibiotic concentration and clinical healing time in diabetic foot infections: a meropenem-focused analysis
Abstract
Aims: The penetration of antibiotics used to treat diabetic foot infection (DFI) into the target tissue is critical for clinical success. This study aimed to evaluate the penetration rates of carbapenem antibiotics into wound fluid, the factors affecting this penetration, and the effects of this penetration on clinical healing time in patients with DFI.
Methods: Twenty patients aged ≥18 years with DFI and open, draining wounds were prospectively included in the study. Thirteen patients received meropenem, four received ertapenem, and three received imipenem. After steady state had been achieved, wound fluid and serum samples were analyzed for antibiotic concentrations using LC–MS/MS.
Results: In accordance with quantitative measurement standards, the analyses focused on the meropenem group (n = 13). A linear relationship was observed between serum and wound fluid meropenem concentrations. Wound fluid meropenem concentrations were significantly higher in patients with lower Wagner stages and in those receiving hyperbaric oxygen therapy (HBOT). Patients with comorbid chronic diseases had significantly higher wound fluid meropenem concentrations than those without comorbidities (p = 0.034). A correlation was observed between wound fluid meropenem concentrations and clinical healing parameters.
Conclusion: Meropenem penetration into wound fluid during the treatment of DFI is influenced by factors such as comorbidities, wound stage, and HBOT. Monitoring antibiotic concentrations in wound fluid may help optimize treatment, reduce costs, and inform decisions regarding the timing of surgery.

Keywords : Diabetic foot infection, meropenem, wound fluid concentration, pharmacokinetics, Wagner grade

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Ethical Statement

This study was approved by the Gülhane Military Medical Academy Command Clinical Researches Ethics Committee (Date: 24.12.2015, Decision No: 2015-KAEK-59).

Informed Consent

Written informed consent was obtained from all individual participants prior to their inclusion in the study. Participants were fully informed about the study’s aims, procedures, potential risks and benefits, and their rights-including the right to withdraw at any time without consequence. All participants voluntarily signed a written informed consent form.

Author Contributions

Concept: YÇ, OD; Design: YÇ, OD; Control: YÇ, OD; Data Collection and/or Processing: YÇ, OD; Analysis and/ or Interpretation: YÇ, OD; Literature Review: YÇ; Provision of Cases/Equipment: YÇ, OD; Article Writing: YÇ, OD; Critical Review: YÇ, OD.

Conflict of Interest

The authors declare no conflicts of interest related to this study.

Financial Disclosure

The authors received no financial support for the conduct or publication of this research.


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Article available in :
Volume 4, Issue 4, 2026
Page : 94-97
https://doi.org/10.51271/JOCS-0084
Article Information
Received : 24 Eyl 2026
Accepted : 24 Eki 2026
Published : 28 Eki 2026
Corresponding Author :

Yavuz Çekli: Department of Infectious Diseases and Clinical Microbiology, Ankara Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkiye

[email protected]
Citation : Çekli Y, Demirtaş O. Relationship between wound fluid antibiotic concentration and clinical healing time in diabetic foot infections: a meropenem-focused analysis. J Compr Surg. 2026;4(4):94-97. doi:10.51271/JOCS-0084

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