Prescription pattern of antibiotics in the skin and soft tissue infections in patients with diabetes mellitus: Experience from a tertiary care teaching hospital
Journal Title: Medpulse International Journal of Pharmacology - Year 2018, Vol 8, Issue 2
Abstract
Objectives: To report the clinical presentation of various skin and soft tissue infections, antimicrobial therapy and the outcomeofin diabetic patients.Methods: A retrospective descriptive study. Results: The prescriptions of 200 diabetic patients (Type 2=199) with a mean age of 58 years were analysed. There were more males than females (67:33). Retired personnel (35.0%) comprised a greater part of the study population, followed by homemakers (32%), and agriculturists (23%). Hypertension was the common comorbidity (13.5%). Diabetic ulcer (n=84, 42.0%), cellulitis (n=48, 24.0%) and gangrene of foot (n=31, 15.5%) were common presentations. Sensory, as well as motor neuropathy, was significant in 179 diabetic foot infections. None had peripheral autonomic neuropathy and vascular insufficiency. The most common isolated bacterial organism was Staphylococcus aureus and Streptococcus species. All received topical treatment and systemic medications. Iodine dressing for wounds (160, 80.0%) was done. Oral therapy (35%)(amoxicillin+ calvulinic acid 20%, metronidazole + cephradine 12%, cefixime -3%) and parenteral (65%) administration of antibiotics were given; Of latter, combination of Ceftriaxone and metronidazole was preferred in 66 (33.0%), ceftriaxone alone in 55 (27.5%), combination of metronidazole with amoxicillin clavulunate (n=39,19.5%),Cephradine (n=24, 12.0%), cefotaxime (n=10, 5.0%) were prescribed. Infection was controlled with antibiotics in 119 (59.5%) patients without any further procedure. Wound debridement (16.0%), disarticulation of left interphalangeal/metatarsophalangeal joint (9.5%), split-thickness skin graft (7.5%) were performed. We noted clinical improvement in 99.0% patients. Conclusion: Diabetic foot infections are most common in patients with diabetes mellitus. Mixed infections require combination therapy including appropriate broad-spectrum antimicrobials. Surgical procedures may be needed to control infection.
Authors and Affiliations
Nicole Rosita Pereira, Vijayalaxmi .
Keywords
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- EP ID EP471397
- DOI 10.26611/1010831
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