874. Diabetic foot ulcers and previous antibiotic use
Session: Poster Abstract Session: Bone, Joint, and Soft Tissue Infection
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
Background: The infection of the feet in diabetic patients is a frequent complication, complex, costly, determining the immediate amputation of the affected limb in 25% to 50% of cases.

Methods: The objective of this study was to evaluate antibiotic use in anti-infective treatment in patients admitted with diabetic foot. It was conducted a cross-sectional study involving 100 diabetic patients with infectious complications in the lower limbs, admitted to the Conjunto Hospitalar de Sorocaba – São Paulo-Brazil. Individuals included in this study underwent an interview through structured inquire and additional data were collected from medical records. In order to identify variables independently associated with progression to amputation in diabetic patients proceeded to the analysis with the cox multiple regression (with robust variance) using variables with p values less than 0.25 by univariate analysis.

Results: The patients' ages ranged from 31.9 to 89.7 years. Most refer to monitoring of diabetes (79%), but admission glucose levels were high (74-517mg/dl, mean 224.7mg dl). The most prevalent chronic complications were neuropathy (91%) and peripheral vascular disease (63%). Most of the patients had diabetic foot neuroischemic (86%) and 75% of patients presented with ulcers of Wagner grade 4. By Morisky test, 71% of patients were categorized as non-compliant with treatment and medication most used were antidiabetics (84%). Prior use of antibiotics was observed in 66% of cases and during hospitalization, 95% of patients received antibiotics. During hospitalization, 61% of patients progressed to amputation, 14% with debridement and 9% with revascularization. The results show a 42% increased risk of progression to amputation in patients who have prior antibiotic use and suggest an increased risk of 26% for the less adherent to medication. Moreover, it was noted that for an increasing degree in the classification criteria of ulcer by Wagner was an increase of 65% risk of amputation

Conclusion: Adherence to treatment and prevention of diabetic foot through educational measures should be encouraged in public health services and requires a multidisciplinary approach, avoiding the progression of chronic complications and ulcers progress to more advanced levels, which would risk higher amputation

Fernando Del Fiol, PHD, UNIVERSITY OF SOROCABA, Cerquilho, Brazil and Maria Teresa Quilici, School of Medicine - PUC SP, Sorocaba, Brazil


F. Del Fiol, None

M. T. Quilici, None

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