Antibiotic therapy for diabetic foot infections: comparison of two parenteral-to-oral regimens.
This prospective, randomized, multicenter trial compared the efficacy of two antibiotic regimens for treatment of foot infections in diabetic adults. Patients with infections requiring hospitalization were randomized to receive either intravenous ofloxacin followed by oral ofloxacin or intravenous ampicillin/sulbactam followed by oral amoxicillin/clavulanate (the aminopenicillin regimen) for 14-28 days. Patients with osteomyelitis were eligible for the study if the infected bone was to be removed. Of 108 patients enrolled in the study, 88 who were evaluable had various skin and soft-tissue infections, and 24% had osteomyelitis. For the ofloxacin and aminopenicillin regimens, the mean duration of intravenous therapy was 7.8 and 7.1 days, respectively, the mean duration of oral therapy was 13.2 and 12.0 days, respectively, the rate of eradication of pathogens was 78% and 88%, respectively, and the overall rate of clinical cure or improvement was 85% and 83%, respectively. Thus, about 3 weeks of therapy with either regimen was well tolerated and effective in treating these diabetic foot infections.
Lipsky
B A
BA
Antibiotic Research Clinic, Veterans Affairs Puget Sound Health Care System, University of Washington School of Medicine, Seattle 98108, USA.
Baker
P D
PD
Landon
G C
GC
Fernau
R
R
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000494:pharmacology; D000667:Ampicillin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology*; D019818:Clavulanic Acid; D002969:Clavulanic Acids / Q000494:pharmacology*; D017719:Diabetic Foot / Q000188:drug therapy* / Q000382:microbiology; D004359:Drug Therapy, Combination; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000494:pharmacology*; D010406:Penicillins / Q000494:pharmacology*; D011446:Prospective Studies; D013407:Sulbactam / Q000494:pharmacology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002969:Clavulanic Acids; D010406:Penicillins; D019818:Clavulanic Acid; D000667:Ampicillin; D000658:Amoxicillin; D015242:Ofloxacin; D013407:Sulbactam