The In-Practice Prescribing Pattern for Antibiotics in the Management of Diabetic Foot: Needs Much More to be done!

    Published on:
    Journal of Young Pharmacists, 2009; 1(4):374-377
    Clinical Pharmacy | doi:10.4103/0975-1483.59331

    Ali N, Rehman S, Imran M, Hussian I, Shehbaz N, Jamshed H, Hayat A1, Khan S2, Anwar MJ3

    Department of Pharmacy, University of Malakand, Chakdara, Dir. N-W.F.P,

    1Post Graduate Medical Institute, Government Lady Reading Hospital (LRH), Peshawar, N-W.F.P,

    2Hayatabad Medical Complex (HMC) Hospital, Peshawar. N-W.F.P,

    3Khyber Teaching Hospital (KTH), Peshawar. N-W.F.P, Pakistan.


    More than 850 patients’ medication history forms were evaluated, retrospectively, for possible irrationalities in the prescribing pattern of antibiotics for management of hospitalized diabetic foot cases. Primary anti-diabetic therapy included insulin, oral anti-diabetic, or combination of both. Supportive therapy included antibiotics for diabetic foot cases and other physical measures like routine wound dressings and washing. Antibiotic therapy was analyzed based on the reported medical literature. It was deduced that in addition to other supportive measures advised for the management of diabetic foot, the antibiotic therapy for management of diabetic foot (n=410) was in the order of ceftriaxone (83.3%) > co-amoxiclav (36.66%) > clindamycin and ciproß oxacin (26.66%) > cefuroxime and levoß oxacin (10.0%) > clarithromycin and cefoperazone / sulbactam, cephradine and fusidic acid (6.6%) > cefotaxime sodium and oxytetracyclin (3.33%). Placing ceftriaxone as a Þ rst choice (83.3%) in the antibiotic therapy carries no logic as ceftriaxone has low activity against reported higher incidence (85 %) of gram-positive organisms such as Staphylococcus aureus and streptococcus species. Prescribing irrationality of antibiotics is a global phenomenon that shall be addressed right from the medical/pharmacy schools levels.

    Key words: Antibiotic, ceftriaxone and co-amoxiclav, diabetes mellitus, diabetic foot, mean age.