A Prospective Observational Study on Prescribing Pattern in Diabetic Foot Ulcer in A Tertiary Care Hospital-Salem

Abstract

Background : Diabetic foot ulcer is a one of the serious and potentially limb-threatening complication of diabetes mellitus  and is associated with substantial morbidity and healthcare burden . Ulceration can be complicated by infection ,particularly when the infection extends into deeper soft tissues or bone, potentially resulting in osteomyelitis ,sepsis ,and lower -limb amputation. Objective : The present study sought to describe the prescribing patterns followed in the  management of diabetic foot ulcers and to identify potential gaps in medical selection with particular focus on the use of antibiotics ,antidiabetics, and supportive therapies . Methods :  The present study adopted a prospective observational design over six months in 100 patients diagnosed with diabetic foot ulcer and admitted to a tertiary care hospital. Eligible patients were enrolled based on predefined inclusion and exclusion criteria .Relevant patients details ,clinical characteristics of diabetic foot ulcers ,and prescribed medications,including antibiotics ,antidiabetic agents , and supportive therapy ,were systematically collected and evaluated to describe the prescribing pattern. Results: The male cases were predominant (59%) among 100 patients and the highest age group was 40-55 years (44%).The most common ulcer grade was Wagner Grade 4 (25%) followed by the grades of 2 and 3 (24% each).The most common organisms isolated were Pseudomonas (27%), MRSA (25%) and MSSA (23%).Piperacillin–tazobactam (19%), ampicillin–sulbactam (14%) and linezolid (12%) were the most frequently used antibiotics.Broad-spectrum antibiotics were often prescribed overall especially patients with higher Wagner grade. Conclusion: A high proportion of advanced DFUs and variety of microbial profile was shown in the study.The most common organisms detected were Pseudomonas spp and MRSA.Piperacillin–tazobactam was the most commonly used antibiotic.The results highlight the need for culture directed antibiotic choice and antimicrobial stewardship.To achieve the best possible outcomes, it is important to optimise glycaemic control and to provide full diabetic foot care.