Analysis of antibiotics administration in diabetic ulcer patients at Panembahan Senopati regional hospital Bantul
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20213003Keywords:
Diabetic ulcers, Antibiotics, Antibiotic guidelinesAbstract
Background: This study provides an overview of diabetic ulcer infection, antibiotic susceptibility patterns, the most common types of antibiotics, factors influence in antibiotics administrations, and verifying the guideline used of antibiotics.
Methods: The research used descriptive analysis combined with interviews. The study was starting from February-March 2021. Eighty-six diabetic ulcer patients were selected considering the inclusion and exclusion criteria. We interviewed seven doctors.
Results: 71 bacterias were found with a gram-negative bacteria count of 80.3%- higher than gram-positive bacteria (19.7%). The most common gram-negative bacteria found are Escherichia coli (12.7%) and show the most heightened sensitivity with imipenem (80.7%), while cefuroxime and trimethoprim-sulfamethoxazole show the highest resistance (64.9%). The most common gram-positive bacteria found are Staphylococcus aureus (14.1%), and vancomycin shows the most heightened sensitivity (100%), while penicillin shows the highest resistance (71.4%). The most common single antibiotic administration was ceftriaxone, as well as a combination of two antibiotics, namely ceftriaxone and metronidazole.
Conclusions: Escherichia coli was the most gram-negative bacteria, which has the highest sensitivity with imipenem, while Staphylococcus aureus was the most gram-positive bacteria, which has the most heightened sensitivity with vancomycin. The most common single antibiotic administration was ceftriaxone, as well as a combination of two antibiotics, ceftriaxone and metronidazole. Factors that influence antibiotics administration are patient condition, susceptibility testing, training, and advice from colleagues. Every doctor uses different guidelines for diabetic foot ulcer.
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References
Perim MC, Borges JC, Celeste SRC, Orsolin EF, Mendes RR, Mendes GO, et al. Aerobic Bacterial Profile and Antibiotic Resistance In Patient WIth Diabetic Foot Infections. Rev Soc Bras Med Trop. 2015;48(5):546-54.
Yusuf S, Okuwa M, Irwan M, Rassa S, Laitung B, Thalib A, et al. Prevalence and Risk Factor of Diabetic Foot Ulcers in a Regional Hospital, Eastern Indonesia. Open Journal of Nursing. 2016;6:1-10.
Riset Kesehatan Dasar (Riskesdas). Laporan Nasional RISKESDAS . Jakarta: Badan Litbang Kesehatan Kemenkes RI. 2018.
Zubair NS, Ahmad J. Diabetic Foot Ulcer: A Review on Pathophysiology, Classification and Microbial Etiology. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2015;9:192-99.
Radji M, Putri CS, Fauziyah S. Antibiotic Therapy for Diabetic Foot Infections in a Tertiary Care Hospital in Jakarta, Indonesia. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2014;8:221-24.
Edgar PJG, Lipsky AB. Diagnosis and Management of Infection in the Diabetic Foot. Med Clin N Am. 2013;97:911-46.
Llor CB. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Therapeutic Advances in Drug Safety. 2014;5(6):229-41.
Chen LF, Chopra T, Kaye KS. Pathogens Resistant to Antibacterial Agents. Infect Dis Clin N Am. 2018;23:817-45.
Peraturan Menteri Kesehatan Republik Indonesia Nomor 2406. Pedoman Umum Penggunaan Antibiotik. Jakarta: Departemen Kesehatan Republik Indonesia. 2011.
Fitria E, Nur A, Marissa N, dan Ramadhan N. Karakteristik Ulkus Diabetikum pada Penderita Diabetes Mellitus di RSUD dr. Zainal Abidin dan RSUD Meuraxa Banda Aceh. . Buletin Penelitian Kesehatan. 2017;45(3):153-60.
Akbar GT, Karimi J, Anggraini D. Pola Bakteri dan Resistensi Antibiotik pada Ulkus Diabetik Grade Dua di RSUD Dr. Arifin Achmad Periode 2012. Jurnal Online Mahasiswa. 2014;1(2):5-12.
Jain A. A new Classification of diabetic foot complications: A simple and effective teaching tool. Journal of Diabetic Foot Complication. 2012;1-5.
Rahmawati M, Maulidya V, Ramadhan AM. Kajian Kesesuaian Pemilihan Antibiotik Empiris Pada Pasien Ulkus Diabetikum Di Instalasi Rawat Inap Rumah Sakit Abdul Wahab Sjahranie Samarinda. Samarinda: Proceeding of the 8th Mulawarman Pharmaceuticals. 2018.
Lipsky BA, Berendt AR, Comia PB, Pile JC, Peters EJG, Armstrong DG. Infectious Disease Society of America Clinical Practice Guideline for The Diagnosis and Treatment of Diabetic Foot Infections. Infectious Disease Society of America Guidline. 2012;132-73.
Sulistyaningsih, Runtuboi DYP, Waworuntu LV. Sensitivitas Antibiotik Terhadap Bakteri yang Diisolasi dari Ulkus Diabetika di RSUD Abepura, Kota Jayapura. JURNAL BIOLOGI PAPUA. 2014;6(2):53-9.
Benwan KA, Mulla AA, Rotimi VO. A Study of the Microbiology of Diabetic Foot Infections in a Teaching Hospital in Kuwait. Journal of Infection and Public Health. 2012;1-8.
Lai CC, Lee K, Xiao Y, Ahmad N, Veeraraghavan B, Thamlikitkul V et al. High Burden of Antimicrobial Drug Resistance in Asia. Journal of Global Antimicrobial Resistance. 2014;7.
Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes. Inter Society Consensus for the Management of Peripheral Arteria Disease. Journal of Vascular Surgery. 2010;45(1).
Umadevi S, Kumar S, Joseph. NM, Easow JE, Kandhakumari G, Sreenivasan S et al (2011). Microbiological Study of Diabetic Foot Infections. Indian Journal of Medical Specialities 2, no.1
Sanchez-Sanchez M, Cruz-Pulido WL, Camara-Bladinieres E, Alcala-Duran R. Bacterial Prevalence and Antibiotic Resistance in Clinical Isolates of Diabetic Foot Ulcers in The Northeast of Tamaulipas Mexico. The International Journal of Lower Extremity Wounds.2017;1-6.
Leekha S. General Principles of Antimicrobial Theraphy. . Mayo Clinic Proceedings. 2011;86(2).
Rezal, Salmi R, Hassali MA, Alrasheedy A, Saleem F, Aryani F, et al. Physicians’ Knowledge, Perceptions and Behaviour towards Antibiotic Prescribing: A Systematic Review of the Literature. Expert Review Anti-Infective Therapy. 2015;13(5):665-80.
Zubair M, Malik A, Ahmad J. Diabetic Foot Ulcer: A Review. American Journal of Internal Medicine. 2015;3(2):28-49.
Rodrigues AT, Roque F, Falcao A, Figueiras A, Herdeiro MT. Understanding Physician Antibiotic Prescribing Behaviour: A Systematic Review of Qualitative Studies. International Journal of Antimicrobial Agents. 2013;41(3):203-12.
Calbo E, Alvarez-Rocha L, Gudiol F, Pasquau J. A review of the factors influencing antimicrobial prescribing Review of the factors influencing the prescription of antibiotics. Infectious Diseases and Clinical Microbiology. 2013;12-5.
Sabtu N, Enoch DA, Brown NM. Antibiotic Resistance: What, Why ,Where, When and How? British Medical Bulletin. 2015;105-13.
Davey P, Brown E, Charani E. Interventions to Improve Antibiotic Prescribing Practis for Hospital Inpatients. Chocrane Database Syst Rev. 2013.
Perhimpunan Dokter Spesialis Penyakit Dalam Indonesia. Panduan Praktik Klinis Penatalaksanaan di Bidang Ilmu Penyakit Dalam. Jakarta; Interna Publishing, 2015. 125-128p.