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Chinese Journal of Injury Repair and Wound Healing(Electronic Edition) ›› 2024, Vol. 19 ›› Issue (05): 398-403. doi: 10.3877/cma.j.issn.1673-9450.2024.05.005

• Original Article • Previous Articles    

Clinical observation of optimized anti-infective treatment model to improve the prognosis of diabetic foot infection

Shan Jiang1, Xiangyan Li2, Shuohan Tian3, Bing Wen1, Rui He1, Xin Qi1,()   

  1. 1. Department of Plastic Surgery and Burns, Peking University First Hospital, Beijing 100034, China
    2. Department of Infectious Disease, the Institute of Clinical Pharmacology, Peking University First Hospital, Beijing 100034, China
    3. Department of Pharmacy, Peking University First Hospital, Beijing 100034, China
  • Received:2023-12-17 Online:2024-10-01 Published:2024-10-08
  • Contact: Xin Qi

Abstract:

Objective

To establish a new multidisciplinary anti-infective treatment model for diabetic foot infections(DFI) and evaluate its effect.

Methods

A before-after study was conducted. The medical charts of inpatients with DFI admitted between October 1, 2016 and March 31, 2018 (control group, n=48) were reviewed retrospectively. Inpatients diagnosed with DFI between April 1, 2018 and September 30, 2019 were prospectively enrolled as the optimization group, in which a team of physicians from plastic and burn department, anti-infective department and pharmacist participated in the anti-infective treatment of patients in the early stage and throughout the whole process(optimization group, n=52). The general condition, characteristics of DFI, treatment and prognostic indicators of the two groups were compared.

Results

As to general condition, compared with the control group, the patients in the optimization group had a longer course of diabetes foot ulcer (120 d vs 30 d, P<0.05) and a higher proportion of peripheral neuropathy (80.8% vs 54.2%, P<0.05); As to characteristics of DFI, compared with the control group, the patients in the optimization group had more sites of osteomyelitis (P<0.05) and a higher proportion of polymicrobial infections (48.1% vs 10.0%, P<0.05); However, as to treatment and prognostic indicators, compared with the control group, the patients in the optimization group received adequate initial empirical treatment more frequently (86.5% vs 31.3%, P <0.05), and had a shorter median duration of fever(1.5 d vs 8.0 d, P <0.05). Rates of healing and relapse within one year were similar between the groups.

Conclusion

The optimized multidisciplinary anti-infective treatment model with early and full participation of physicians from plastic and burn department, anti-infective department and pharmacist is conducive to the treatment of diabetic foot infection and improves the prognosis of patients.

Key words: Diabetic foot infection, Infectious disease, Antibiotic use

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