Prospective, Randomized Comparison of Ampicillin/Sulbactam and Cefoxitin for Diabetic Foot Infections

The purpose of this prospective, randomized, double-blind investigation was to compare two different parenteral antibiotics (ampicillin/sulbactam and cefoxitin) in conjunction with appropriate surgical procedures for treatment of patients with diabetic foot infec tions on a vascular surgery service. Thirty-six patients with diabetes mellitus who required hospitalization to treat foot infections were randomized into one of two treatment groups. There were 18 patients with similar baseline characteristics random ized to each treatment group. The Chi-square test was used for clinical and bacteriolog ical comparisons, the Wilcoxon rank sum test was used for comparing duration of hospi talization and clinical signs and symptoms, and Fisher's Exact Test (two-tailed) was used to compare treatment outcomes of the two groups. Based on intention-to-treat analysis, there was no significant difference in treatment outcome (cure + improved) between the ampicillin/sulbactam (15/17) and cefoxitin groups (16/17). Similarly, no significant differences in bacteriologic response were noted. Both ampicillin/sulbactam and cefoxitin, when combined with appropriate surgical interventions, are safe and effective therapies for treating foot infections in patients with diabetes mellitus.