Impact of dedicated infectious disease teamwork on the treatment and prognosis of patients with diabetic foot infection

Objective: To develop and evaluate the impact of a new model in which the infectious disease (ID) physician and pharmacist work together to treat diabetic foot infections (DFIs).

Methods: We conducted a quasi-experimental before-after study. We retrospectively reviewed the medical charts of inpatients with DFI admitted between 1 April 2017 and 31 March 2018 (control group, n = 30). Inpatients diagnosed with DFI between 1 April 2018 and 31 March 2019 were prospectively enrolled as the intervention group and received treatment through dedicated ID teamwork (intervention group, n = 35).

Results: The distribution of infection severity and level of metabolic criteria were similar between the groups. Compared with the control group, the intervention group received adequate initial empirical treatment more frequently (43.5% vs 96.8%, p < 0.001), and had a shorter median duration of fever (7.5 vs 1 day, p < 0.001). Rates of healing and relapse within six months were similar between the groups, although the intervention group showed more sites of osteomyelitis (p = 0.036) and a higher percentage of polymicrobial infections (48.6% vs 10.0%, p = 0.001).

Conclusion: The early and full participation of ID physicians and pharmacists in the treatment of DFI facilitates targeted antimicrobial treatment and improves patient outcomes.

Keywords: Antibiotic use; Diabetic foot infection; Infectious disease.