article · Open Journal of Medical Research (ISSN 2734-2093)
A retrospective review of one hundred and fifty diabetic foot ulcer patients treated at two hospitals in Abuja, Nigeria, examined bacterial profiles, prescribing practices, and clinical outcomes. Most patients presented with moderate to severe wounds categorised as grade two or grade three on the Wagner Scale. All isolated bacterial pathogens were aerobic, with Staphylococcus aureus identified as the most frequent organism. Prescribing patterns differed significantly between the two facilities, with ceftriaxone being the most commonly selected single agent alongside multi-drug combination regimens. However, antibiotic choices were not influenced by the severity of the ulcer or the specific bacterial isolate detected. Clinical outcomes were unsatisfactory for nearly sixty percent of patients, resulting in partial healing, amputations, or deaths. The findings highlight an urgent need for standard clinical guidelines to improve patient outcomes and combat antimicrobial resistance.
Diabetic foot ulcers represent severe complications that carry high risks of tissue loss, limb amputation, and death. When antibiotic regimens are administered without alignment to specific bacterial pathogens or wound severity, recovery rates drop significantly. Understanding regional prescribing habits and patient outcomes is essential for establishing standardised clinical stewardship programmes that improve wound recovery and curb the threat of drug resistance.
The findings can inform hospital administrators, health policy bodies, and diagnostic developers seeking to design standardised clinical stewardship protocols or point-of-care microbiological testing tools. While the research demonstrates an immediate clinical need for targeted diagnostic-led prescribing, it represents an observational retrospective study rather than a commercial product or trial, meaning any resulting diagnostic or therapeutic interventions remain at an early development stage.
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Some diabetics may develop chronic wounds on the lower limbs called Diabetic Foot Ulcers (DFUs). Antibiotics are a major component of DFU management. This study, a retrospective cross-sectional study, sought to determine patterns and effectiveness, antibiotics prescribed for DFUs at National Hospital, Abuja (NHA), and University of Abuja Teaching Hospital (UATH), for one hundred and fifty (150) DFU patients. On the Wagner Scale, 63 (42.0%) patients, and 51 (34.0%) were at DFU grades 3 and 2, respectively. All bacteria isolated were aerobic. The most and least frequently isolated bacteria were Staphylococcus aureus, at a frequency of 52 (34.7%), and coagulase-negative staphylococci, at a 4 (2.7%) frequency. No statistical association existed between ages and isolates, nor between gender and Isolates (p>0.05). More patients accessed care at NHA, 61.3%, while 36.7% attended UATH. NHA prescribed more antibiotics, 95 (61.3%), and 55 (36.7%) at UATH. While ceftriaxone was most prescribed, 28 (18.6%), Clindamycin and Erythromycin were least prescribed, 1 (0.6%). Clindamycin/Ceftriaxone/Vancomycin, 34 (22.6%), and Ceftriaxone/Vancomycin, 26 (17.3%), were prescribed as combinations. There were differences in antibiotic prescription rates between the two hospitals (p < 0.011). Neither the DFU grade nor isolated bacteria (p=0.05) influenced antibiotic prescription. More patients, 89 (59.4%) had unsatisfactory treatment outcomes; 67 (44.7%) had partial healing, 61 (40.7%) had complete healing, amputations were 17 (11.3%), while deaths, or no improvements, were 4 (2.7%) and 1 (0.7%). Guidelines should be instituted on antibiotic use to promote positive DFU treatment and mitigate the emergence of antibiotic resistance.
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DOI: 10.52417/ojmr.v6i1.893
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