Type of publication:
*Lefroy R.; Summerour V.; *McMullen K.; Corfield L.
British Journal of Surgery; Sep 2019; vol. 106, S5, p. 165
Aim: The National Institute for Clinical Excellence has established evidence-based guidelines for the
management of diabetic foot infection. These follow basic principles of treating infections with broad spectrum
antibiotics until cultures provide more accurate guidance for antibiotic treatment. This audit aimed to assess
the practice of a tertiary vascular centre against this guideline, to bring in measures to improve practice and
then to re-examine this practice.
Method(s): Data was collected retrospectively for all patients who underwent an emergency operative
intervention for a diabetic foot infection under the care of vascular surgery (n=122). Data collection focused on
microbiological samples sent and antibiotics prescribed. The results were shared with the surgical unit and the
guidelines reiterated. A proforma was trialled and one month of patients with diabetic foot infection admitted
as emergencies were prospectively reviewed.
Result(s): Initially, we showed that only 36% had microbiological samples sent at the time of their procedure. Of these, almost half were on antimicrobial therapy not tailored to sensitivities. Following education and
instigation of our proforma, we demonstrated that 77% of patients had samples and improving rates of
appropriate antibiotic prescriptions.
Conclusion(s): Our data demonstrates significant improvement in these patients management. Doctors must
check sensitivities of samples to ensure antibiotic stewardship.
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