Evaluation of Adherence to Empiric Antibiotic Recommendations in Treatment of Diabetic Foot Infections

Abstract

Objectives: 1. To compare appropriateness of therapy and the time it takes for appropriate empiric antibiotic therapy to be given from when patients are first admitted for treatment of diabetic foot infection. 2. To compare the time it takes for physicians to “streamline” therapies or switch from empiric antibiotic therapy to specific antibiotics after culture results are obtained 3. To Compare the incidence of readmission within 30 days to the hospital after initial discharge. Methods: In this IRB approved, retrospective study, antibiotic therapy prescribing patterns before and after the distribution of a health network specific empiric antibiotic reference material were compared in patients admitted for diabetic foot infection. Patients were excluded if no antibiotic therapy prescribed, if under the age of 18 years, or if admitted for less than 48 hours (including time spent in the emergency department). The following data were collected and analyzed between the two groups: number of appropriate antibiotic therapy administered, timing of appropriate therapies relative to when appropriate culture samples were obtained if applicable, time it takes to streamline antimicrobial therapy, and the incidence of 30-day readmission. Results: A total of 400 patients were evaluated with 17 pre-intervention and 10 post-intervention patients who meet the inclusion criteria. The pre- and post- intervention groups did not show significant difference in demographics except for comorbid conditions (p=0.055). Overall, there was no significant difference between the pre- and post-intervention group on appropriate empiric therapy given (p=0.382), timing to streamline therapy (p=0.4035), and readmission rates (p=0.401). Conclusions: The health network specific empiric antibiotic recommendations reference material did not influence the timing and appropriateness of empiric antibiotic therapy in treatment of diabetic foot infections and the patient 30-day readmission rates.