A study on bacteriological profile and prescription pattern of antibiotics in the management of diabetic foot ulcers in a tertiary healthcare teaching hospital

Infection of diabetic foot ulcers is the most common cause of hospitalization among diabetic patients. If not treated properly in time, the infection will eventually lead to septicemia, amputation and even death. It is found that more than 40 percent of amputations can be prevented by the appropriate treatment of diabetic foot ulcers. Irrational antibiotic use leads to treatment failure adverse drug reactions, superinfections, prolongation of treatment, increased cost and development of antibiotic resistance. Study of the bacteriological profile, antimicrobial susceptibility and prescription pattern aids in evaluating the rationality of antibiotic therapy and promote rational drug use and quality of life of patients.
Aims and objectives: To study the prevalence and antibiogram of causative organisms, and the prescription pattern of antibiotics used in the treatment of diabetic foot infection.
Methodology: The retrospective study is conducted for a period of 6 months. Case records of 210 patients were selected based on the study criteria. A suitably designed data collection form was used to collect the required data. Statistical analysis was done using Microsoft Excel.
Results: Males (77.6%) were more prone to diabetic foot infections. Hypertension (42%) was the most common comorbidity. Staphylococcus aureus (16%) was the most frequently isolated bacteria and most of the infections were monomicrobial (63.8%). Cephalosporin class of antibiotics (34.6%) were most commonly prescribed. Clindamycin (26.6%) was the commonest empirical antibiotic. Out of 273 bacterial isolates, 229 isolates showed resistance to one or more antibiotics.
Conclusion: Since there is no antibiotic except for Tigecycline which is 100% sensitive in both Gram-negative and Gram-positive bacteria, it is recommended to prescribe a combination of highly effective antibiotics for empirical therapy.