Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options?
Background: The choice of empiric antibiotics in Diabetic Foot Infection (DFI) is a key to successful therapy. Meanwhile, the management of DFI in Indonesia is based on guideline originating from western countries which have different bacteriological patterns. Therefore, this study aimed to describ...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Interna Publishing
2022-04-01
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| Series: | Acta Medica Indonesiana |
| Subjects: | |
| Online Access: | https://actamedindones.org/index.php/ijim/article/view/1982 |
| _version_ | 1818530024073986048 |
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| author | Hikmat Permana Aluisha Saboe Nanny NM Soetedjo Dewi Kartika Bachti Alisjahbana |
| author_facet | Hikmat Permana Aluisha Saboe Nanny NM Soetedjo Dewi Kartika Bachti Alisjahbana |
| author_sort | Hikmat Permana |
| collection | DOAJ |
| description | Background: The choice of empiric antibiotics in Diabetic Foot Infection (DFI) is a key to successful therapy. Meanwhile, the management of DFI in Indonesia is based on guideline originating from western countries which have different bacteriological patterns. Therefore, this study aimed to describe the bacterial and antibiotic susceptibility pattern on DFI which potentially contribute to better antibiotics selection guidelines. Methods: This was a cross-sectional descriptive study conducted using consecutive sampling with DFI patients admitted in the emergency room and wards of Hasan Sadikin Hospital between February and July 2020. Tissue samples were obtained from all wounds, while antibiotic susceptibility tests were carried out on the culture results. Results: A total of 65 bacterial growths were obtained from 45 enrolled patients. Gram-negative bacteria dominated with 54 growths (83.07%) including Klebsiela pneumonia 13 (20%) as the most common. Furthermore, antibiotics with good susceptible (> 80%) against Gram-negative bacteria are the carbapenemes (meropenem and ertapenem) and amikacin. The multi drug resistant bacteria were found in 18 growths (27.7%), which include ESBL, Carbapenemase producing bacteria, and MRSA. However, there were no susceptibility pattern differences between patients with ulcer duration above or below 2 months, higher grade wound (Wagner 4 and 5) and lower, as well as patients with previous or no antibiotic history. Conclusion: The growth of Gram-negative bacteria dominated DFI with limited susceptibility to the empirical first-line antibiotics in the known international guidelines. Therefore, there is a need to reconsider the algorithm for selecting empirical antibiotics and management of DFI which is appropriate in our current condition. |
| first_indexed | 2024-12-11T17:14:29Z |
| format | Article |
| id | doaj.art-4f54be5e736a4cee8e01791c9247a845 |
| institution | Directory Open Access Journal |
| issn | 0125-9326 2338-2732 |
| language | English |
| last_indexed | 2024-12-11T17:14:29Z |
| publishDate | 2022-04-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj.art-4f54be5e736a4cee8e01791c9247a8452022-12-22T00:57:23ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322022-04-01542509Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options?Hikmat Permana0Aluisha Saboe1Nanny NM Soetedjo2Dewi Kartika3Bachti Alisjahbana4Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, IndonesiaResearch Center for Care and Control of Infectious Diseases, Universitas Padjadjaran, Bandung, Indonesia.1. Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, Indonesia. 2. Department of Clinical Pathology, Faculty of Medicine Universitas Padjadjaran - Hasan Sadikin Hospital, Bandung, Indonesia.Background: The choice of empiric antibiotics in Diabetic Foot Infection (DFI) is a key to successful therapy. Meanwhile, the management of DFI in Indonesia is based on guideline originating from western countries which have different bacteriological patterns. Therefore, this study aimed to describe the bacterial and antibiotic susceptibility pattern on DFI which potentially contribute to better antibiotics selection guidelines. Methods: This was a cross-sectional descriptive study conducted using consecutive sampling with DFI patients admitted in the emergency room and wards of Hasan Sadikin Hospital between February and July 2020. Tissue samples were obtained from all wounds, while antibiotic susceptibility tests were carried out on the culture results. Results: A total of 65 bacterial growths were obtained from 45 enrolled patients. Gram-negative bacteria dominated with 54 growths (83.07%) including Klebsiela pneumonia 13 (20%) as the most common. Furthermore, antibiotics with good susceptible (> 80%) against Gram-negative bacteria are the carbapenemes (meropenem and ertapenem) and amikacin. The multi drug resistant bacteria were found in 18 growths (27.7%), which include ESBL, Carbapenemase producing bacteria, and MRSA. However, there were no susceptibility pattern differences between patients with ulcer duration above or below 2 months, higher grade wound (Wagner 4 and 5) and lower, as well as patients with previous or no antibiotic history. Conclusion: The growth of Gram-negative bacteria dominated DFI with limited susceptibility to the empirical first-line antibiotics in the known international guidelines. Therefore, there is a need to reconsider the algorithm for selecting empirical antibiotics and management of DFI which is appropriate in our current condition.https://actamedindones.org/index.php/ijim/article/view/1982diabetic foot infectionantibiotic susceptibilitybacterial pattern |
| spellingShingle | Hikmat Permana Aluisha Saboe Nanny NM Soetedjo Dewi Kartika Bachti Alisjahbana Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options? Acta Medica Indonesiana diabetic foot infection antibiotic susceptibility bacterial pattern |
| title | Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options? |
| title_full | Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options? |
| title_fullStr | Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options? |
| title_full_unstemmed | Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options? |
| title_short | Empirical Antibiotic for Diabetic Foot Infection in Indonesian Tertiary Hospital, Is It Time to Rethink the Options? |
| title_sort | empirical antibiotic for diabetic foot infection in indonesian tertiary hospital is it time to rethink the options |
| topic | diabetic foot infection antibiotic susceptibility bacterial pattern |
| url | https://actamedindones.org/index.php/ijim/article/view/1982 |
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