A prospective observational study of drug prescription pattern of antibiotics in diabetic foot ulcer in tertiary care teaching hospital

Abstract

Background: Our aim was to study a prescribing pattern of antibiotics used in diabetic foot ulcer (DFU).Methods: 50 patients were selected by inclusion and exclusion criteria basis. It was a prospective observational study conducted in Department of Surgery, Rajah Muthiah Medical College Hospital (RMMCH), Annamalai University.Results: This study reveals that male patients 60% are more prone to develop diabetic foot ulcer than the female patients 40%. Patients of 50 to 60 age group 32% has higher prevalence of DFU. The most commonly prescribed antibiotics are metronidazole 48% and cefotaxime 48% followed by piperacillin and tazobactam combination 30%, ciprofloxacin 20%, linezolid 18%, amoxicillin and clavulanic acid combination 12%, cefixime 6%, clindamycin 4%, amikacin 4%, faropenam 4%, ceftriaxone 2%, amoxicillin 2%, gentamicin 2%, cefoperazone sodium and sulbactam combination 2%.Conclusions: Lack of antibiotic sensitivity test leads to growth of organism, wrong antibiotic selection and irrational use of antibiotics. And also observed patient developed resistance to linezolid antibiotic when used as a first choice of drug to treat diabetic foot infection including methicillin-resistant Staphylococcus aureus (MRSA) infected patients.

Optimizing Antibiotic Treatment for Diabetic Foot Infections: A Study From a Tertiary Public Healthcare Center in Puducherry, South India

“…Other antibiotics such as ciprofloxacin, clindamycin, linezolid, amoxicillin, gentamicin, and amikacin were used. These findings are also consistent with existing literature [ 8 , 11 , 21 - 22 ]. Furthermore, the point on polypharmacy correctly highlights the importance of essentially deprescribing or prescription pruning seconding the findings of Narayan et al [ 23 ].…”

“…Necrotizing soft tissue infection (NSTI) was observed in 57.3% (n = 63) of cases, while trophic ulcers and osteomyelitis affected 19.1% (n = 21) and 8.2% (n = 9) of the participants, respectively. Treatment modalities included oral hypoglycemic agents (79.1%, n = 87) and insulin (20.9%, n = 23), with 84.5% (n = 93) of patients undergoing wound debridement and 15.5% (n = 17) requiring amputation, mirroring previous findings [ 11 , 17 , 19 - 20 ].…”

“…The demographic profile revealed that the majority (n = 43, 39%) of the participants fell within the 51-60 age range, with males constituting 72.7% (n = 80) of the sample, aligning closely with previous research [ 14 ]. Male predominance in DFIs is often linked to their occupational activities requiring outdoor exposure [ 11 , 15 - 16 ]. Risk factors identified in our study included low socioeconomic status, barefoot walking habits, and poor glycemic control (HbA1C > 8%), consistent with findings from other populations [ 7 , 11 , 16 ].…”

“…Male predominance in DFIs is often linked to their occupational activities requiring outdoor exposure [ 11 , 15 - 16 ]. Risk factors identified in our study included low socioeconomic status, barefoot walking habits, and poor glycemic control (HbA1C > 8%), consistent with findings from other populations [ 7 , 11 , 16 ].…”

“…Sample size determination relied on previously published data, indicating an incidence of DFIs ranging between 8% and 10% in the Indian population [ 11 ]. The following formula was used:…”