J Korean Foot Ankle Soc.  2009 Dec;13(2):146-149.

Analysis of Initial Choice Antibiotics Efficacy in Diabetic Foot Infection

Affiliations
  • 1Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, Korea. osmedic@ajou.ac.kr

Abstract

PURPOSE
Foot infections are common complications in patients with diabetes. The patients are usually immune-compromised; therefore the pathogens could be resistant to narrow spectrum antibiotics. Those drugs, however, are categorized as specially managed antibiotics, and access are difficult without confirming of the pathogens. Our aim was to analyze the common pathogens in diabetic foot infection and figure out the proper antibiotics.
MATERIALS AND METHODS
We studied 68 patients treated with diabetic foot infection. The pathogens which caused the infection and their sensitivity to initial antibiotics were analyzed. We also investigated the change of the antibiotics after the confirming of the culture result and average time to get the result.
RESULTS
Among the 68 patients, 56 (82%) received cephalosporin and beta-lactam antibiotics. Only 12 (18%) who were confirmed the drug resistant pathogens from previous culture, were treated with broad spectrum antibiotics such as vancomycin and tazoperan. Average culture study time was 6 days. Methicillin-resistant staphylococcus aureus (MRSA) was cultured in 19 patients (28%), Methicillin-resistant coagulase negative staphylococcus (MRCNS) in 11 patietns (17%), pseudomonas in 11 patients (17%). Total 44 (65%) including 3 of other antibiotics resistant pathogen needed broad spectrum antibiotics. Thirty two patients (47%) were resistant to initial antibiotics.irt follow up culture, 2 MRSA and 2 MRCNS were found. The antibiotics resistant pathogens were confirmed in 48 (71%) patients at last.
CONCLUSION
Diabetic patients with foot infection need proper antibiotics from initial treatment. The proper broad spectrum antibiotics should assigned to the patients from the first time without the confirming of the culture results.

Keyword

Diabetic foot infection; Antibiotics; Resistant bacteria; Sensitivity

MeSH Terms

Anti-Bacterial Agents
Coagulase
Diabetic Foot
Follow-Up Studies
Foot
Humans
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Pseudomonas
Staphylococcus
Vancomycin
Anti-Bacterial Agents
Coagulase
Vancomycin
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