SUSCEPTIBILITY PATTERN AND ANTIBIOTIC THEURAPETIC EFFECTIVITY BASED ON DIABETIC NEUROPATHY SCORE (DNS), DIABETIC NEUROPATHY EXAMINATION (DNE) AND WAGNER OF DIABETIC ULCERS PATIENTS
Abstract
Diabetes Mellitus complication is influenced by duration and
succesfull of DM control. Uncontrolled DM patient have 2 - 3
times risk of infection. Metabolic disorders result to neuropathy
and ischemia in the legs and feet. This may lead to a diabetic
ulcers which are the most common complication. According to
Wagner diabetic ulcers are classified into five categories. Neuropathy
diabetic may be examined by DNE (Diabetic Neuropathy
Examination) and DNS (Diabetic Neuropaty Score). The optimal
therapy of diabetic ulcers were undetermined, because of the
bacteria involved and the efficacy of antibiotics therapy remains
unclear. The aims of the study is to determine the pattern of
antibiotic sussceptibility and the role of antibiotic therapy in the
management of diabetic ulcers. Prospective cohort study, crosssectional
experimental laboratory design and pre-test - post test
randomized control group design. There are 38 subjects involved,
26%o men and 74Yo women. No significant differences in terms of
age, initial GDS, the DM duration, the ulcers duration, ulcer
recurrence rate and baseline score of DNS, DNE and wagner. The
proportion of antibiotics which were prescribed including Clinda-
90
mycin, Cefadroxil, Ceftriaxon, Amoxicillin Ciprofloxacin and cefotaxime
were 13.2%, 5.3o/", 28.9%, 18-4%, 23.7% and 10'5% respectively'
Antibiotics therapy did not significantly influence the effectiveness of
treatment acording to the DNS, DNE and Wagner. The relative risk of
each antibiotic therapy were computed and results showed:
Clindamycin (RR = 2.571) and Cefotaxim (RR = 2.306) based on DNE
scores; Clindamycin (RR = 2-29L) and Ciprofloxacin (RR = 2'880)
based on Wagner. The RR above 2 can be considered as clinically
effective. Cyprofloxacin is the most sensitive antibiotics, followed by
Clindamycin and Cefadroxyl as much as 60'5% and 57'8% respectively'
Six antibiotics did not significantly effective for diabetic ulcers
therapy based on DNS, DNE and Wagner. Clindamycin, Ciprofloxacin
and Cefotaxim might be considered clinically effective'