TY - JOUR
T1 - Evaluation of antimicrobial therapy and patient adherence in diabetic foot infections
AU - Wasnik, Rahul Naresh
AU - Marupuru, Srujitha
AU - Mohammed, Zabiuddin Ahad
AU - Rodrigues, Gabriel Sunil
AU - Miraj, Sonal Sekhar
N1 - Funding Information:
We express our gratitude to Manipal College of Pharmaceutical Sciences and Kasturba Medical College, Manipal Academy of Higher Education, Manipal for the support. Appendix A
Funding Information:
We express our gratitude to Manipal College of Pharmaceutical Sciences and Kasturba Medical College, Manipal Academy of Higher Education, Manipal for the support.
Publisher Copyright:
© 2018
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background/objectives: Diabetic foot infections (DFI) are common complications among diabetics. These wounds can cause discomfort and often become infected. In India, currently there is a paucity of data on patient adherence towards antibiotic use in DFIs. Therefore, this study was aimed to evaluate antimicrobial susceptibility pattern, antimicrobial therapy and its adherence in DFI patients. Method: A prospective observation study (N = 150, newly diagnosed DFI patients) was conducted in Kasturba hospital, Manipal over a period of 6 months. Culture and Sensitivity pattern of the microbes of the patients were obtained from hospital data management system to develop cumulative antimicrobial susceptibility pattern. Medication adherence was measured by using Culig adherence scale at the first follow-up visit. Results: The most common microbes were Methicillin-sensitive Staphylococcus aureus (23.9%), Klebsiella pneumonia (13.3%) and Escherichia coli (13.3%). Inj. Amoxicillin-Clavulanic acid 1.2 gm (28.6%) was highest prescribed empirical therapy in DFI's followed by Inj. Cefuroxime-Sulbactam 2.25 gm (14.6%), Ceftriaxone (0.7%) and Trimethoprim- Sulfamethoxazole (2%) was the most sensitive antibiotic. Cumulative antimicrobial susceptibility pattern shows Chloramphenicol, Colistin, Levofloxacin, Rifampicin has developed resistance towards most of the common organisms in DFI. Statistically significant association was observed between empirical therapy with T.Cefuroxime 625 mg and improved clinical outcomes (p < 0.001). Adherence shows that only 14% of patients have high adherence rates during first follow-up visit. Conclusion: Ceftriaxone and Trimethoprim-Sulfamethoxazole are most sensitive antibiotics towards most common organisms in DFIs. T. cefuroxime 625 mg showed statistically significant improvement in clinical outcomes while adherence is very low in most of the DFI patients.
AB - Background/objectives: Diabetic foot infections (DFI) are common complications among diabetics. These wounds can cause discomfort and often become infected. In India, currently there is a paucity of data on patient adherence towards antibiotic use in DFIs. Therefore, this study was aimed to evaluate antimicrobial susceptibility pattern, antimicrobial therapy and its adherence in DFI patients. Method: A prospective observation study (N = 150, newly diagnosed DFI patients) was conducted in Kasturba hospital, Manipal over a period of 6 months. Culture and Sensitivity pattern of the microbes of the patients were obtained from hospital data management system to develop cumulative antimicrobial susceptibility pattern. Medication adherence was measured by using Culig adherence scale at the first follow-up visit. Results: The most common microbes were Methicillin-sensitive Staphylococcus aureus (23.9%), Klebsiella pneumonia (13.3%) and Escherichia coli (13.3%). Inj. Amoxicillin-Clavulanic acid 1.2 gm (28.6%) was highest prescribed empirical therapy in DFI's followed by Inj. Cefuroxime-Sulbactam 2.25 gm (14.6%), Ceftriaxone (0.7%) and Trimethoprim- Sulfamethoxazole (2%) was the most sensitive antibiotic. Cumulative antimicrobial susceptibility pattern shows Chloramphenicol, Colistin, Levofloxacin, Rifampicin has developed resistance towards most of the common organisms in DFI. Statistically significant association was observed between empirical therapy with T.Cefuroxime 625 mg and improved clinical outcomes (p < 0.001). Adherence shows that only 14% of patients have high adherence rates during first follow-up visit. Conclusion: Ceftriaxone and Trimethoprim-Sulfamethoxazole are most sensitive antibiotics towards most common organisms in DFIs. T. cefuroxime 625 mg showed statistically significant improvement in clinical outcomes while adherence is very low in most of the DFI patients.
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U2 - 10.1016/j.cegh.2018.10.005
DO - 10.1016/j.cegh.2018.10.005
M3 - Article
AN - SCOPUS:85055086129
SN - 2213-3984
VL - 7
SP - 283
EP - 287
JO - Clinical Epidemiology and Global Health
JF - Clinical Epidemiology and Global Health
IS - 3
ER -