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Antibiotic Therapy May Influence Chronic Post-Amputation Pain

by The O&P EDGE
April 9, 2026
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Researchers conducted a study to determine whether prolonged or combined antibiotic regimens may contribute to neuroinflammatory processes that predispose patients with traumatic amputations to chronic post-amputation pain, which combines the concepts of chronic residual limb pain (RLP) and phantom limb pain (PLP). The researchers investigated associations between the duration, type, and combination of antibiotic use and the development of RLP and PLP.

The retrospective cohort study evaluated 212 military personnel treated between 2022 and 2024 for traumatic amputations. Antibiotic regimens, pain intensity, type, and chronicity were analyzed.

Chronic RLP/PLP developed in 94 patients (44.3 percent). Prolonged antibiotic use (>21 days) and combined regimens (≥2 antibiotics) were related to increased chronic post-amputation pain risk in limbs. Neuropathic pain was predominant in patients exposed to fluoroquinolones or metronidazole, the study found, leading the authors to recommend personalized antimicrobial stewardship and early pain screening.

The open access study, “Antibiotic therapy as a risk factor for chronic residual and phantom limb pain after combat-related amputation: A 212-patient cohort study,” was published in the journal Frontiers.

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