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    Managing diabetic foot infections: a survey of Australasian infectious diseases clinicians

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    Author
    Commons, RJ; Raby, E; Athan, E; Bhally, H; Chen, S; Guy, S; Ingram, PR; Lai, K; Lemoh, C; Lim, L-L; ...
    Date
    2018-04-10
    Source Title
    Journal of Foot and Ankle Research
    Publisher
    BIOMED CENTRAL LTD
    University of Melbourne Author/s
    Athan, Eugene; Guy, Stephen
    Affiliation
    Medical Education
    Metadata
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    Document Type
    Journal Article
    Citations
    Commons, R. J., Raby, E., Athan, E., Bhally, H., Chen, S., Guy, S., Ingram, P. R., Lai, K., Lemoh, C., Lim, L. -L., Manning, L., Miyakis, S., O'Reilly, M., Roberts, A., Sehu, M., Torda, A., Vicaretti, M. & Lazzarini, P. A. (2018). Managing diabetic foot infections: a survey of Australasian infectious diseases clinicians. JOURNAL OF FOOT AND ANKLE RESEARCH, 11 (1), https://doi.org/10.1186/s13047-018-0256-3.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253592
    DOI
    10.1186/s13047-018-0256-3
    Abstract
    Background: Diabetic foot infections (DFI) present a major morbidity, mortality and economic challenge for the tertiary health sector. However, lack of high quality evidence for specific treatment regimens for patients with DFIs may result in inconsistent management. This study aimed to identify DFI caseload proportion and patterns of clinical practice of Infectious Diseases (ID) Physicians and Trainees within Australia and New Zealand. Methods: A cross-sectional online survey of Australian and New Zealand ID Physicians and Trainees was undertaken, to estimate the overall ID caseload devoted to patients with DFIs and assess clinicians' management practices of patients with DFIs. Results: Approximately 28% (142/499) of ID Physicians and Trainees from Australia and New Zealand responded to the survey. DFI made up 19.2% of all ID consultations. Involvement in multidisciplinary teams (MDT) was common as 77.5% (93/120) of those responding indicated their patients had access to an inpatient or outpatient MDT. Significant heterogeneity of antimicrobial treatments was reported, with 82 unique treatment regimens used by 102 respondents in one scenario and 76 unique treatment regimens used by 101 respondents in the second scenario. The duration of therapy and the choice of antibiotics for microorganisms isolated from superficial swabs also varied widely. Conclusions: Patients with DFIs represent a significant proportion of an ID clinician's caseload. This should be reflected in the ID training program. Large heterogeneity in practice between clinicians reflects a lack of evidence from well-designed clinical trials for patients with DFI and highlights the need for management guidelines informed by future trials.

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