A Prospective Study on Clinico-Bacteriological Study of Diabetic Foot and the Efficacy of Antibiotic Therapy in a Tertiary Care Hospital in Tirupati

Abstract

BACKGROUND Diabetic foot is the most common and most feared complication of diabetes and is more significant than nephropathy, retinopathy, heart attack, and stroke combined. Diabetes-associated problems are the second common cause of lowerlimb amputations in India. Foot disorders like ulcerations, infection, Gangrene are the leading causes of hospitalization in patients with diabetes mellitus in India.1 METHODS A prospective study, carried out on 100 diabetic patients with foot ulcers over a period of one year from April 2019 to March 2020 at Sri Venkateswara Medical College hospital. The extent of foot infection was assessed based on Wagner’s classification and were studied based on the culture and sensitivity obtained and the efficacy of the antibiotic used. RESULTS The data analysis of 100 patients has given the following results. 70 % (70 patients) of them were culture positive, and 30 % (30 patients) were culture negative. Culture positive patients were divided into two groups with 35 patients each. Group A started on empirical therapy, Group B on sensitive antibiotic therapy. Repeat swab taken on day 7 from the previously culture-positive patients (70 patients), it was found that 30 out of 35 patients of group-A (empirical therapy) were still culture positive with a similar or newer organism, only 5 patients were culture negative, whereas in 35 patients of Group-B (sensitive antibiotic therapy) only 5 patients were culture positive with a similar or newer organism, remaining 30 patients were culture negative. Sensitive antibiotic therapy was found to be effective than empirical therapy in treatment of diabetic foot ulcers. CONCLUSIONS Culture and sensitivity from the wounds play a critical role in prescribing appropriate antibiotic at the time of admission itself rather than starting the empirical treatment. KEYWORDS Diabetic Foot, Culture and Sensitivity, Empirical Antibiotic Therapy