Role of white blood cells, neutrophil and c-reactive proteins as indicator of severity of diabetic foot sepsis and termination of antibiotic administration

Abstract EN

Objective : sepsis has a major role in wound healing and outcome of diabetic foot.

the aim of this study was to evaluate TWBCs, neutrophil and C-reactive protein level, as indicator of severity of sepsis and guide to stop antibiotic therapy.

methods : this prospective cross-sectional study conducted in Jabir Abu Eliz Centre (JADC), Khartoum, Sudan.

Fifty patients with acute foot sepsis were included.

clinical data was recorded in visits 1 at presentation, 2 after two weeks and 3 at the time of wound healing.

the clinical features (fever, generalized fatigability and local foot signs: swelling, redness, hotness, tenderness) were categorized into grades (A, B, C, and D) according to the severity of sepsis.

TWBC, neutrophils and CRP level were done in each visit.

Data were collected and different characteristics were compared, statistically significant was defined when p<0.05.

results : the mean age was 59±10 years, M:F ratio was 3:1.

The mean duration of diabetes 10±2 years.

eighty two percent of patients had neuropathic ulcers.

Levels of TWBCs, neutrophils and CRP, grades of sepsis (A, B, C and D) were correlated, which revealed that CRP-level demonstrated the highest reading in visit 1, and dropped gradually in visit 2 to reach normal level in visit 3 (p=0.04), while TWBCs and neutrophils results showed lesser response.

conclusions : CRP is a good predictor of the severity of foot sepsis and effective follow-up marker.

it may indicate termination of antibiotic therapy.