An audit to review the podiatry supply of flucloxacillin under Prescription Only Medicines exemption (POM-S) in cases of mild infection within Belfast Health and Social Care Trust

Background: The timely treatment of diabetes foot infections is important to prevent the rapid progression of infection, hospital admissions and amputation (Lipsky et al, 2020). Antibiotic therapy is necessary for all diabetes foot infections (NICE, 2019). Podiatrists with HCPC POM-S annotation can supply flucloxacillin 500 mg (one four times a day for 7 days) for mild foot infections (Health and Care Professions Council, 2021). Aim: The aim of this audit was to review the issue of 500 mg of flucloxacillin and assess patient outcomes within community foot protection teams. Methods: The records of all patients diagnosed with mild infection according to International Working Group on the Diabetic Foot (Lipsky et al, 2020) classification, and issued 500 mg of flucloxacillin (one four times a day for 7 days), between 23/8/19–11/09/20, by a podiatrist working in a Community Wellbeing and Treatment Centre within Belfast Health and Social Care Trust were included. All podiatrists were required to adhere to the Safe Operating Procedure for supply of flucloxacillin to patients. Data analysis was performed using Microsoft Excel 2016®. Results: A total of 35 patients were supplied 500 mg of flucloxacillin (one four times a day for 7 days) by a community podiatrist during 23/8/19–11/09/20. Twenty one cases of infection completely resolved and four cases of infection improved. Four patients changed antibiotic after microbiological/radiological investigations. Two cases of infection deteriorated with the patient requiring hospital admission, two cases of infection did not improve due to deteriorating ischaemia and two cases of infection remained static. Conclusions: This audit has shown the supply of flucloxacillin 500 mg (one four times a day for 7 days) by community podiatrists can improve and resolve mild foot infections. It can also ensure timely access to antibiotics avoiding delays in therapy. Podiatrists with HCPC POM-S annotation should utilise supplying for mild foot infection where appropriate.