Study of antibiotic prescribing trends in diabetic foot infections highlights need for ‘rational’ prescribing

A study which assessed antibiotic prescribing trends and microbial susceptibility patterns in diabetic foot infections (DFIs) has highlighted how understanding local microbial patterns is “crucial” for guiding antibiotic choice and optimising patient outcomes.

The team behind the research, which was conducted in a tertiary care centre in Puducherry, India, say the findings provide “valuable insights for strengthening antimicrobial stewardship programmes” and improving patient care in diabetic foot management.

It also highlights the need for “rational” antibiotic prescribing, they say.

The two-month study surgery involved 110 patients attending surgery outpatient departments and those on inpatient wards. The patients were mostly male and aged between 51 and 60.

Common risk factors included poor glycaemic control, barefoot walking, and a family history of diabetes.

Gram-negative organisms predominated (70.9%), with Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus being common isolates.

The team reported: “Polypharmacy was observed, with 57.3% receiving multiple antibiotics, mainly via the parenteral route. Ceftriaxone and cefotaxime were frequently prescribed. Antibiotic resistance varied among isolates.”

Understanding antibiotic prescribing patterns and microbial susceptibility is crucial for effective management of diabetic foot infections, the team said.

They concluded: “This study underscores the predominance of gram-negative organisms in DFIs and highlights the need for rational antibiotic prescribing.

“Cephalosporins were commonly used, emphasising the importance of empirical therapy. Understanding local microbial patterns and susceptibility is crucial for guiding antibiotic selection and optimising clinical outcomes.

“In addition, addressing modifiable risk factors is imperative for preventing DFIs and reducing associated complications.

“This study provides valuable insights for strengthening antimicrobial stewardship programs and improving patient care in diabetic foot management. Furthermore, the present study highlights the importance of essentially deprescribing the prescriptions both from the patient, their primary carer, and the treating physician/surgeon’s perspective.”

Read the study in full here.

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