Evaluation of antimicrobial therapy and patient adherence in diabetic foot infections

Rahul Naresh Wasnik, Srujitha Marupuru, Zabiuddin Ahad Mohammed, Gabriel Sunil Rodrigues, Sonal Sekhar Miraj

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalClinical Epidemiology and Global Health
DOIs
Publication statusAccepted/In press - 01-01-2018

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Diabetic Foot
Patient Compliance
Cefuroxime
Infection
Ceftriaxone
Sulfamethoxazole Drug Combination Trimethoprim
Anti-Bacterial Agents
Colistin
Therapeutics
Sulbactam
Amoxicillin-Potassium Clavulanate Combination
Levofloxacin
Methicillin
Medication Adherence
Klebsiella pneumoniae
Chloramphenicol
Diabetes Complications
Rifampin
Information Systems
Staphylococcus aureus

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Wasnik, Rahul Naresh ; Marupuru, Srujitha ; Mohammed, Zabiuddin Ahad ; Rodrigues, Gabriel Sunil ; Miraj, Sonal Sekhar. / Evaluation of antimicrobial therapy and patient adherence in diabetic foot infections. In: Clinical Epidemiology and Global Health. 2018.
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abstract = "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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Evaluation of antimicrobial therapy and patient adherence in diabetic foot infections. / Wasnik, Rahul Naresh; Marupuru, Srujitha; Mohammed, Zabiuddin Ahad; Rodrigues, Gabriel Sunil; Miraj, Sonal Sekhar.

In: Clinical Epidemiology and Global Health, 01.01.2018.

Research output: Contribution to journalArticle

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

PY - 2018/1/1

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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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