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JYP · Lens · The In-Practice Prescribing Pattern for Antibiotics in the Management of Diabetic Foot: Needs Much More to be done!

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Article · Volume 1, Issue 4 · pp. 375–378

The In-Practice Prescribing Pattern for Antibiotics in the Management of Diabetic Foot: Needs Much More to be done!

Ali N1, Rehman S1, Imran M1, Hussian I1, Shehbaz N1, Jamshed H1, Hayat A2, Khan S3, Anwar MJ4

  1. 1Department of Pharmacy, University of Malakand, Chakdara, Dir. N-W.F.P, INDIA.
  2. 2Post Graduate Medical Institute, Government Lady Reading Hospital (LRH), Peshawar, N-W.F.P, INDIA.
  3. 3Hayatabad Medical Complex (HMC) Hospital, Peshawar. N-W.F.P, INDIA.
  4. 4Khyber Teaching Hospital (KTH), Peshawar. N-W.F.P, INDIA.

Abstract

More than 850 patients’ medication history forms were evaluated, retrospectively, for possible irrationalities in the prescribing pattern of antibiotics for management of hospitalized diabetic foot cases. Primary anti-diabetic therapy included insulin, oral anti-diabetic, or combination of both. Supportive therapy included antibiotics for diabetic foot cases and other physical measures like routine wound dressings and washing. Antibiotic therapy was analyzed based on the reported medical literature. It was deduced that in addition to other supportive measures advised for the management of diabetic foot, the antibiotic therapy for management of diabetic foot (n=410) was in the order of ceftriaxone (83.3%) > co-amoxiclav (36.66%) > clindamycin and ciproß oxacin (26.66%) > cefuroxime and levoß oxacin (10.0%) > clarithromycin and cefoperazone / sulbactam, cephradine and fusidic acid (6.6%) > cefotaxime sodium and oxytetracyclin (3.33%). Placing ceftriaxone as a Þ rst choice (83.3%) in the antibiotic therapy carries no logic as ceftriaxone has low activity against reported higher incidence (85 %) of gram-positive organisms such as Staphylococcus aureus and streptococcus species. Prescribing irrationality of antibiotics is a global phenomenon that shall be addressed right from the medical/pharmacy schools levels.

Keywords: Antibiotic; ceftriaxone and co-amoxiclav; diabetes mellitus; diabetic foot; mean age

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