Antimicrobial stewardship opportunities among inpatients with diabetic foot infections: microbiology results from a tertiary hospital multidisciplinary unit

Robert Hand; Laurens Manning; Jens C Ritter; Paul Norman; Lydia Lamb; Ashley Makepeace; Dipen Sankhesara; Emma Hamilton; Paul Ingram

doi:10.1111/imj.14251

Antimicrobial stewardship opportunities among inpatients with diabetic foot infections: microbiology results from a tertiary hospital multidisciplinary unit

Intern Med J. 2019 Apr;49(4):533-536. doi: 10.1111/imj.14251.

Authors

Robert Hand¹, Laurens Manning^{2

3}, Jens C Ritter⁴, Paul Norman⁴, Lydia Lamb⁵, Ashley Makepeace⁵, Dipen Sankhesara¹, Emma Hamilton^{5

6}, Paul Ingram^{2

7

8}

Affiliations

¹ Department of General Medicine, Fiona Stanley Hospital, Perth, Western Australia, Australia.
² Department of Infectious Diseases, Fiona Stanley Hospital, Perth, Western Australia, Australia.
³ Faculty of Medicine and Health Sciences, University of Western Australia, Harry Perkins Research Institute, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁴ Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁵ Department of Endocrinology, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁶ School of Medicine and Pharmacology, University of Western Australia, Harry Perkins Research Institute, Fiona Stanley Hospital, Perth, Western Australia, Australia.
⁷ School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia.
⁸ Department of Microbiology, PathWest Laboratory Medicine, Perth, Western Australia, Australia.

PMID: 30957374
DOI: 10.1111/imj.14251

Abstract

Among 125 inpatients with diabetic foot infections managed by a multidisciplinary foot ulcer unit, knowledge of methicillin-resistant Staphylococcus aureus colonisation status assisted decision-making to prescribe appropriately or with-hold empiric anti-methicillin-resistant Staphylococcus aureus therapy. Despite adherence to national guidelines, apparent overuse of anti-pseudomonal therapy was frequent, providing potential antimicrobial stewardship opportunities.

Keywords: antimicrobial; diabetic; foot; infection; stewardship.

MeSH terms

Aged
Anti-Bacterial Agents / therapeutic use*
Antimicrobial Stewardship / organization & administration*
Cross Infection / drug therapy
Diabetic Foot / drug therapy*
Female
Hospital Units
Humans
Inpatients
Male
Methicillin-Resistant Staphylococcus aureus / drug effects
Middle Aged
Tertiary Care Centers

Substances

Anti-Bacterial Agents