A Comparative Analysis of Antibiotic Usage in Diabetic Foot Infections Against Healing Time

Kruszewska, Karolina; Wesołowska-Górniak, Katarzyna; Czarkowska–Pączek, Bożena

doi:10.1053/j.jfas.2020.05.024

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…[58] A study carried out in Poland yielding outcomes similar to our findings found that although there was good adherence to local prescribing guidelines, the guidelines themselves did not cover the most common pathogens responsible for DFU infection. [59] Only two patients had samples collected for microbiological testing and culture identification. The subsequent treatment protocols implemented for these patients were found to be non-compliant with local guidelines, but compliant with international guidelines.…”

Section: Researchmentioning

confidence: 99%

The antimicrobial susceptibility patterns of diabetic foot ulcers in the South African public healthcare sector

Turner,

Leigh-de Rapper,

Mokoena

et al. 2024

S Afr Med J

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Background. Diabetic foot syndrome is defined as the presence of a diabetic foot ulcer (DFU) associated with neuropathy, peripheral artery disease and infection. While the use of antimicrobials in the treatment of DFU infection remains a mainstay, the choice of antimicrobial remains problematic owing to the presence of multidrug-resistant polymicrobial infections. In the South African public healthcare sector, the treatment of DFUs is based on the Standard Treatment Guidelines (STGs) and the Essential Drug List. These guidelines are developed using evidence-based medicine and are based on global susceptibility patterns rather than local susceptibility data, and may not provide the most appropriate treatment options. Objectives. To determine the antimicrobial susceptibility patterns of DFUs isolated from patients visiting selected Gauteng provincial public hospitals in order to determine a clinically effective treatment protocol for the management of these infections. Methods. Sample swabs were taken from 51 DFUs using the Levine method. Each sample swab was spread onto blood agar plates, and thereafter individual pathogens were isolated. The antimicrobial susceptibility patterns of all isolated pathogens were determined using zone of inhibition measurements. Pathogens were grouped according to macromorphological characteristics as well as susceptibility patterns, and a representative isolate from each group was then identified. Results. A total of 51 DFU ulcer swabs from 45 patients were included in the study. From the sample swabs, a total of 445 pathogens were isolated. The most effective antimicrobial was found to be gentamicin, followed by ciprofloxacin. Amoxicillin/clavulanic acid, the first-line treatment according to the STGs, was found to be ineffective for many of the isolated pathogens. The most commonly isolated pathogens were Proteus mirabilis, Enterococcus faecalis and Pseudomonas aeruginosa. Conclusion. These findings demonstrate the urgent need to reassess the STGs and base treatment plans on local epidemiological data. This study provides valuable data on common causative pathogens in DFU infections, as well as the resistance patterns of these pathogens, forming a baseline on which to base future DFU treatment plans.

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Section: Researchmentioning

confidence: 99%

The antimicrobial susceptibility patterns of diabetic foot ulcers in the South African public healthcare sector

Turner,

Leigh-de Rapper,

Mokoena

et al. 2024

S Afr Med J

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Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge

Maurer

Hepp

McCallin

et al. 2022

J. Bone Joint Infect.

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Abstract. Diabetic foot infection is a frequent complication in long-standing diabetes mellitus. For antimicrobial therapy of this infection, both the optimal duration and the route of administration are often based more on expert opinion than on published evidence. We reviewed the scientific literature, specifically seeking prospective trials, and aimed at addressing two clinical issues: (1) shortening the currently recommended antibiotic duration and (2) using oral (rather than parenteral) therapy, especially after the patient has undergone debridement and revascularization. We also reviewed some older key articles that are critical to our understanding of the treatment of these infections, particularly with respect to diabetic foot osteomyelitis. Our conclusion is that the maximum duration of antibiotic therapy for osteomyelitis should be no more than to 4–6 weeks and might even be shorter in selected cases. In the future, in addition to conducting randomized trials and propagating national and international guidance, we should also explore innovative strategies, such as intraosseous antibiotic agents and bacteriophages.

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A Comparative Analysis of Antibiotic Usage in Diabetic Foot Infections Against Healing Time

Cited by 2 publications

References 23 publications

The antimicrobial susceptibility patterns of diabetic foot ulcers in the South African public healthcare sector

The antimicrobial susceptibility patterns of diabetic foot ulcers in the South African public healthcare sector

Short and oral antimicrobial therapy for diabetic foot infection: a narrative review of current knowledge

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