PMID- 36864766
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230411
IS  - 2093-2340 (Print)
IS  - 2092-6448 (Electronic)
IS  - 1598-8112 (Linking)
VI  - 55
IP  - 1
DP  - 2023 Mar
TI  - Evaluation of the Use of Antimicrobial Therapy for Treating Diabetic Foot 
      Infections in an Indonesia Referral Hospital: A Retrospective Cohort Study.
PG  - 80-89
LID - 10.3947/ic.2022.0084 [doi]
AB  - BACKGROUND: Diabetic foot infection (DFI) is a common complication of 
      hyperglycemia and is related to prolongation of hospitalization, mortality, high 
      hospitalization costs and decreased quality of life. Antibiotic therapy is one of 
      the most critical factors in the eradication of infection. This study aims to 
      determine the appropriateness of antibiotic use based on the local and 
      international clinical guidelines and its short-term effect on patients' clinical 
      improvement. MATERIALS AND METHODS: This retrospective cohort study was conducted 
      using secondary data from DFI inpatients from 1 January 2018 to 31 May 2020, from 
      Dr. Cipto Mangunkusumo Hospital (RSCM), the National Referral Hospital of 
      Indonesia. The Gyssens algorithm was used to help assess the appropriateness of 
      antibiotics. All subjects were type 2 Diabetes Mellitus (T2DM) adult patients 
      diagnosed with DFI. The primary outcome was a clinical improvement of infection 
      after 7 - 14 days of antibiotic use. The clinical improvement of infection was 
      defined by a minimum of three of these criteria: reduced or no purulent 
      secretions, no fever, the area around the wound did not feel warm, no or reduced 
      local oedema, no local pain, reduced redness or erythema, and decreased 
      leukocytes count. RESULTS: A total of 113 (63.5%) eligible subjects from a total 
      of 178 were recruited. Among the patients, 51.4% had a duration of T2DM for >/=10 
      years, 60.2% had uncontrolled hyperglycemia, 94.7% had a history of 
      complications, 22.1% had a history of amputation, and 72.6% had ulcer grade >/=3. 
      Based on the Gyssens algorithm, 54.0% of the subjects were given antibiotics 
      appropriately, while the other 46.0% were not. The proportion of improved 
      patients in the appropriate antibiotics group was higher but not statistically 
      significant than those in the inappropriate group (60.7% vs. 42.3%, P = 0.079). 
      However, the results of the multivariate analysis demonstrated that the 
      appropriate use of antibiotics would increase clinical improvement by 2.6 times, 
      compared to inappropriate use after controlling for the covariates (adjusted odds 
      ratio: 2.616, 95% confidence interval: 1.117 - 6.126, P = 0.027). CONCLUSION: 
      Only half of the patients with DFI received appropriate antibiotics, although an 
      appropriate antibiotics usage was independently associated with better short-term 
      clinical improvement in DFI. This suggests that we should effort to improve 
      appropriateness in antibiotics usage in DFI.
CI  - Copyright (c) 2023 by The Korean Society of Infectious Diseases, Korean Society for 
      Antimicrobial Therapy, and The Korean Society for AIDS.
FAU - Aviatin, Memy
AU  - Aviatin M
AUID- ORCID: 0000-0001-8087-1110
AD  - Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
FAU - Sauriasari, Rani
AU  - Sauriasari R
AUID- ORCID: 0000-0001-7861-4369
AD  - Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia. 
      rani@farmasi.ui.ac.id.
FAU - Yunir, Em
AU  - Yunir E
AUID- ORCID: 0000-0002-2004-9050
AD  - Division of Endocrinology, Department of Internal Medicine Dr. Cipto Mangunkusumo 
      National Referral Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, 
      Indonesia. e.yunir@ui.ac.id.
FAU - Risni, Hindun Wilda
AU  - Risni HW
AUID- ORCID: 0000-0002-8000-6992
AD  - Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
LA  - eng
GR  - NKB-93/UN2.RST/HKP.05.00/2020/Ministry of Research and Higher Education/Indonesia
GR  - NKB-2692/UN2.RST/HKP.05.00/2020/Ministry of Research and Higher 
      Education/Indonesia
PT  - Journal Article
DEP - 20230223
PL  - Korea (South)
TA  - Infect Chemother
JT  - Infection & chemotherapy
JID - 101531537
PMC - PMC10079441
OTO - NOTNLM
OT  - Antibiotics
OT  - Clinical improvement
OT  - Diabetic foot
OT  - Infection
COIS- No conflict of interest.
EDAT- 2023/03/04 06:00
MHDA- 2023/03/04 06:01
PMCR- 2023/03/01
CRDT- 2023/03/03 02:02
PHST- 2022/06/11 00:00 [received]
PHST- 2022/12/26 00:00 [accepted]
PHST- 2023/03/04 06:01 [medline]
PHST- 2023/03/04 06:00 [pubmed]
PHST- 2023/03/03 02:02 [entrez]
PHST- 2023/03/01 00:00 [pmc-release]
AID - 55.e6 [pii]
AID - 10.3947/ic.2022.0084 [doi]
PST - ppublish
SO  - Infect Chemother. 2023 Mar;55(1):80-89. doi: 10.3947/ic.2022.0084. Epub 2023 Feb 
      23.