Publication:

A prospective study to assess the pharmacotherapeutic management of chronic diabetic foot ulcers in a tertiary care hospital

Background Chronic diabetic foot ulcers (DFUs) are a major cause of morbidity, prolonged hospitalization, and non-traumatic lower-limb amputations in patients with diabetes mellitus. Effective management requires rational pharmacotherapy, appropriate antimicrobial use, and objective wound assessment. This study evaluated pharmacotherapeutic management, drug utilization using World Health Organization (WHO) prescribing indicators, microbiological profile, and clinical outcomes in patients with chronic DFUs admitted to a tertiary care teaching hospital.

Methods A 12-month prospective observational study was conducted in collaboration with the Departments of Pharmacology and General Surgery. Forty-two patients aged ≥30 years with chronic DFUs were enrolled after Institutional Ethics Committee approval and informed consent. Drug utilization was assessed using WHO/INRUD prescribing indicators. Wound healing was evaluated using the leg ulcer measurement tool (LUMT) at baseline, 1 week, and 4 weeks. Wound swabs were subjected to microbiological analysis, and data were analyzed using descriptive statistics.

Results Most patients were males aged 41–60 years. Wound cultures were positive in 57.1% of cases, with Escherichia coli and Staphylococcus aureus being the predominant isolates. Polypharmacy was common (mean 6.8 drugs/prescription), although most medications were prescribed from the Essential Medicines List. β-lactams and nitroimidazoles were the most frequently prescribed antimicrobials. Mean LUMT scores decreased significantly over four weeks, indicating improved wound healing, and clinical cure was achieved in 78.6% of patients.

Conclusion Rational pharmacotherapy guided by WHO prescribing indicators, culture-directed antimicrobial therapy, and standardized wound assessment using LUMT were associated with significant clinical improvement in patients with chronic diabetic foot ulcers.