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Correlation between Empirical Antibiotic Therapy and Bone Culture Results in Patients with Osteomyelitis

Tardáguila-García, Aroa, DPM, PhD; Lázaro-Martínez, José Luis, DPM, PhD; Sanz-Corbalán, Irene, DPM, PhD; García-Álvarez, Yolanda, DPM, PhD; Álvaro-Afonso, Francisco Javier, DPM, PhD; García-Morales, Esther, DPM, PhD

Advances in Skin & Wound Care: January 2019 - Volume 32 - Issue 1 - p 41–44
doi: 10.1097/01.ASW.0000542527.48815.1f

OBJECTIVE: To analyze the correlation between empirical antibiotic therapies prescribed in primary care centers by general practitioners and the microbiology results of bone culture in patients with diabetic foot–related osteomyelitis.

METHODS: This observational study involved 80 patients with diabetic foot ulcers and clinically suspected osteomyelitis. The patients were taking antibiotics prescribed by general practitioners to treat diabetic foot infections. Bone samples were taken from every patient for microbiology analysis in a specialized diabetic foot unit.

MAIN OUTCOME MEASURE: The sensitivity of the bone cultures to antibiotics was compared with the patient’s previous antibiotic therapy, and antibiotic and bacterial resistance were analyzed.

MAIN RESULTS: The bone cultures from only 16 patients (22.3%) showed sensitivity to the antibiotics that the patient had been prescribed. Fifty-six patients (77.8%) displayed bacterial resistance to the antibiotic that they were taking.

CONCLUSIONS: Awareness and implementation of international antibiotic stewardship guidelines are poor in primary care centers. It is important to establish strategies that foster a better understanding of treatment management standards and ensure the proper implementation of guidelines.

In the Diabetic Foot Unit, Universidad Complutense de Madrid, in Madrid, Spain, Aroa Tardáguila-García, DPM, is a Podiatrist; José Luis Lázaro-Martínez, is Head of Diabetic Foot Unit; Irene Sanz-Corbalán, DPM, PhD, is a Podiatrist; Yolanda García-Álvarez, is Podiatrist; Francisco Javier Álvaro-Afonso, DPM, PhD, is a Podiatrist; and Esther García-Morales, DPM, PhD, is Chief Resident.

The authors have disclosed no financial relationships related to this article.

Submitted January 19, 2018; accepted in revised form March 29, 2018.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.