One consequence of inadequately managed diabetic foot infections is amputation. Every 30 seconds, somewhere in the world, a lower limb is lost as a complication of diabetes, and the incidence of amputation reportedly ranges from 2.1 to 13.7 per 1000 persons. More than 50% of nontraumatic amputations of the lower extremity involve patients with diabetes.

Individuals who have already undergone amputation of one limb are at high risk for amputation of the contralateral limb. Within 5 years of an initial major amputation, 50% of patients will have died, and 30% to 50% of first-episode amputations will progress to subsequent amputations within 1 to 3 years.
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In 2003, O’Brien and colleagues provided a comprehenĀ­sive cost estimate of several complications of diabetes in Canada. They noted that the cost of a first lower-extremity amputation in a patient with diabetes was Can$24 583 per year in 2000.1 Extrapolated to 2007, that cost would be Can$30 896 per year.

Considering the substantial economic burden of diabetĀ­ic foot infections and their associated consequences, optimal management is needed to reduce the incidence of limb amputations and infection-related morbidity and mortality. Canadian guidelines for the treatment of diabetic foot infections have been developed and published; however, they have not been updated since the 1990s. Conversely, the IDSA has published guidelines more recently, but it is not known if these guidelines lead to cost-effective decisions.
Therefore, this study was undertaken to examine the following research question: What drug or drugs recommended by the IDSA guidelines are cost-effective for the treatment of mild diabetic foot infections in Canada? It was hoped that this cost information would be helpful to clinicians considering options for the treatment of diabetic foot infections. In theory, such information should allow better management of diabetic foot infections and should reduce the associated complications, while limiting drug expenditures.
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Category: Diabetes / Tags: antibiotic, Canada, cost-effectiveness, diabetic foot infection, oral therapy, pharmacoeconomics

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