Ampicillin/sulbactam and cefoxitin in the treatment of cutaneous and other soft-tissue abscesses in patients with or without histories of injection drug abuse.

Abstract

A randomized, double-blind trial compared the clinical and bacteriologic efficacy of ampicillin/sulbactam (2 g/1 g) and cefoxitin (2 g) administered intravenously every 6 h to patients with (n=49) or without (n=47) histories of injection drug abuse who presented with cutaneous or other soft-tissue infections. Cure or improvement occurred in 89.8% of ampicillin/sulbactam-treated patients, compared with 93.6% of cefoxitin-treated patients. The median time to resolution of all symptoms was 10.5 days with ampicillin/sulbactam treatment and 15.5 days with cefoxitin treatment. Mixed aerobic-anaerobic infection was encountered frequently in both treatment groups. A significantly higher percentage of Streptococcus species was found in the major abscesses of the patients with histories of injection drug abuse, compared with those without such histories (37% vs. 19%, respectively; P=.0009). Overall, ampicillin/sulbactam eradicated pathogens from the major abscesses in 100% of patients, whereas the eradication rate with cefoxitin was 97.9%. The 2 drugs were well tolerated. Ampicillin/sulbactam and cefoxitin were equally effective for the empirical treatment of cutaneous or other soft-tissue infections in injection drug abusers and patients who did not inject drugs.

• Authors: D A Talan, P H Summanen, S M Finegold
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 31 Issue 2 Pg. 464-71 (Aug 2000) ISSN: 1058-4838 [Print] United States
• PMID: 10987706 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Cephamycins
• sultamicillin
• Cefoxitin
• Ampicillin
• Sulbactam

Topics

• Abscess (complications, drug therapy, microbiology)
• Adult
• Ampicillin (therapeutic use)
• Bacteria (classification, isolation & purification)
• Bacterial Infections (drug therapy, microbiology)
• Cefoxitin (therapeutic use)
• Cephamycins (therapeutic use)
• Double-Blind Method
• Drug Therapy, Combination (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Skin Diseases, Bacterial (complications, drug therapy, microbiology)
• Soft Tissue Infections (complications, drug therapy, microbiology)
• Substance Abuse, Intravenous (complications)
• Sulbactam (therapeutic use)