Journal Article

Ampicillin/Sulbactam and Cefoxitin in the Treatment of Cutaneous and Other Soft-Tissue Abscesses in Patients With or Without Histories of Injection Drug Abuse

David A. Talan, Paula H. Summanen and Sydney M. Finegold

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 31, issue 2, pages 464-471
Published in print August 2000 | ISSN: 1058-4838
Published online August 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313971
Ampicillin/Sulbactam and Cefoxitin in the Treatment of Cutaneous and Other Soft-Tissue Abscesses in Patients With or Without Histories of Injection Drug Abuse

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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.

Journal Article.  4389 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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