ECE2023 Eposter Presentations Late Breaking (91 abstracts)
Effectiveness of empirical antibiotic therapy in diabetic foot infection in a Portuguese Center
Juliana Gonçalves 1,2 , André Guimarães 2,3 , Helena Urbano Ferreira 1,2 , Sara Ribeiro 1,2 , Telma Moreno 1,2 , Marta Borges-Canha 1,2 , Fábia Silva 4 , Maria Clara Correia 4 , Jorge Pedro 1,2 , Nélia Neves 2,3 , Ricardo São Simão 4 , Paulo Andrade 2,3,5 , Maria de Lurdes Santos 2,3,6 , Davide Carvalho 1,2 & Paula Freitas 1,2
1Centro Hospitalar Universitário de São João, Department of Endocrinology, Diabetes and Metabolism, Porto, Portugal, 2Universidade do Porto, Faculty of Medicine, Porto, Portugal, 3Centro Hospitalar Universitário de São João, Department of Infectious Disease, Porto, Portugal, 4Centro Hospitalar Universitário de São João, Department of Orthopedic and Traumatology, Porto, Portugal, 5Centro Hospitalar Universitário de São João, Unidade de Prevenção e Controlo de Infeção e Resistência aos Antimicrobianos (UPCIRA), Porto, Portugal, 6Centro Hospitalar Universitário de São João, Unidade de Cuidados Intensivos de Doenças Infeciosas, Porto, Portugal
Introduction: Diabetic foot infection imposes a significant burden and is a major cause of non-traumatic limb amputation. Antibiotic therapy plays a crucial role in the management these patients. In our institution, empirical antibiotic therapy is tailored to the presence of risk factors for multidrug-resistant microorganisms. For patients without risk factors, empirical intravenous amoxicillin-clavulanate at a dose 2.2 g every 8h is used. For patients with risk factors such as previous hospitalization or antibiotic therapy in the last 3 months, or hemodialysis, empirical intravenous vancomycin and piperacillin-tazobactam (P/T) at a dose of 4.5 g every 6 hours is recommended.
Objective: To assess the adequacy of empirical antibiotic therapy recommended in our protocol in relation to microbial isolates.
Methods: We conducted a retrospective cohort study that included patients who were hospitalized for neuropathic diabetic foot infection on a tertiary refferal hospital between January 2020 and December 2022. Tissue specimens (biopsy or aspiration of purulent exudate) were aseptically collected from the ulcer for culture. Demographic, clinical, and microbiological data were collected.
Results: Fifty-one patients were enrolled in this cohort, 69% of whom were male, with a mean age of 58.9±11.9 years, and 73% of whom had type 2 diabetes mellitus. Two-thirds of cases were classified as PEDIS 3, and one-third as PEDIS 4. Sixty-one percent of patients had risk factors for multidrug-resistance. A total of 108 microorganisms were identified (an average of 2.7 pathogens per patient). S. aureus was the most frequently identified pathogen (20%), and P. aeruginosa was the most frequent Gram-negative bacteria (10%). Fourteen percent of S. aureus and 58% of coagulase-negative Staphylococcus were methicillin-resistant, and 35% of Enterobacterales were resistant to P/T. All P. aeruginosa were sensitive to P/T. Overall, by applying our treatment guidelines, antibiotic coverage of the identified pathogens was achieved in 75% of cases (84% in patients with risk factors, and 60% in patients without risk factors
Conclusion: Not initiating broad-spectrum antibiotic therapy in all cases reduces the risk of antibiotic resistance emergence (at the possible expense of a lower percentage of initial empirical coverage in patients without risk factors for multirrestance). To avoid compromising patient outcomes, it is essential to collect samples for culture as early as possible. Our study highlights the high adequacy of empirical antibiotic therapy protocols that take into consideration risk factors for multidrug-resistant microorganisms, which ultimately improves the outcomes of these patients.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more