Evaluation of the Surgical and Pharmacological Treatment of Diabetic Foot Infection: A Retrospective Study

Abstract

BACKGROUND: Diabetic foot infection is a major cause of patient disabilities and lowers limb amputations, with high treatment costs and hospitalisation requirements.
 AIM: Aim of this study was to evaluate surgical wound care plus antibiotic effects in the treatment of mild and moderate diabetic foot infections.
 METHODS: This retrospective study involved 60 patients with diabetic foot infections with or without osteomyelitis. The patients were categorised as group 1 mild and group 2 moderate. Both groups were treated using local wound debridement and the systemic administration of antibiotics. Group 1 (16) patients were treated with two regimens of oral antibiotics in two regimens, A (amoxicillin/clavulanate + metronidazole) and B (clindamycin + metronidazole), for 10-14 days. Group 2 (42) patients were treated with oral plus intravenous antibiotics in two regimens, A (ampicillin + cloxacillin + metronidazole) and B (lincomycin + metronidazole), for 6 weeks. The patients followed-up with local wound care specialists for 3 months to evaluate the treatment outcomes (cure, improvement, or failure).
 RESULTS: Group 1 had an 80% cure rate under regimen A and a 100% cure rate under regimen B. Group 2 regimen A patients had a 61.5% cure rate and 11.53% improved, while regimen B patients had a 68.75% cure rate and 12.5% improved. Failure in both regimens was 23.8% in 20 patients with osteomyelitis, while 35% were cured and 20% improved during the study period.
 CONCLUSION: Local surgical wound care for 3 months with antibiotic regimens for 6 weeks resulted in good response and cure rates, with lower costs and fewer instances of hospitalisation. Intravenous lincomycin and oral metronidazole achieved higher cure responses for moderate diabetic foot infections.

Antibiotic Evaluation Use towards Diabetic Foot Ulcer Inpatient at Hospital in Surakarta

“…The antibiotic regimen given must be adjusted to the severity and the infecting bacteria (Lipsky et al, 2012). In this study, there are seven classes of , 2015), so it can be chosen as an empirical antibiotic before bacterial culture is performed to determine the definitive antibiotic that is suitable for the infecting bacteria (Aliakbar et al, 2019;Susanti et al, 2016). Appropriate indication criteria is the administration of a drug or therapy that must be adjusted to the disease suffered by the patient, and the disease must be correct following the doctor's diagnosis (Ministry of Health of Republic Indonesia, 2021).…”

Aerobic Bacteria Isolated From Diabetics Foot Infection Locally and Antibiotics Influence

“…The primary objective in the treatment of diabetes is to decrease the progression of macro and microvascular complications. There is evidence that the risk can be significantly reduced and prevent the development of complications in all types of diabetes if well-controlled blood glucose levels [25,26] . The management of both high blood pressure and blood lipids is beneficial both to patients, as well as physical activity, reducing stress and a smoke-free lifestyle [27,28] .…”