cefoxitin and Foot-Diseases

The efficacy and safety of ceftizoxime and cefoxitin were compared in a randomized, double-blind study of therapy for lower extremity infections in patients with diabetes mellitus or peripheral vascular disease. Overall clinical responses were satisfactory in 82% (23/28) of patients treated with ceftizoxime and in 68% (17/25) of patients treated with cefoxitin. The difference was not statistically significant. Ceftizoxime had superior in vitro activity against Enterobacteriaceae, especially Enterobacter cloacae, whereas cefoxitin had better activity against the Bacteroides fragilis group. Relapses of infection were common in both groups during long-term follow-up; only about one third of patients in either group maintained satisfactory outcomes after one year. More than half of the patients in both groups responded to one or more courses of medical therapy and avoided major amputations for one year following entry into the study.

Topics: Aged; Bacterial Infections; Cefotaxime; Cefoxitin; Ceftizoxime; Clinical Trials as Topic; Diabetes Complications; Double-Blind Method; Female; Follow-Up Studies; Foot; Foot Diseases; Humans; Ischemia; Male; Middle Aged; Prospective Studies; Random Allocation; Recurrence

An 84-year-old man was admitted to the hospital with a diabetic foot ulcer and osteomyelitis of the calcaneum. While being treated with cefoxitin sodium, he experienced generalized exfoliative dermatitis, which subsided on discontinuation of therapy. To our knowledge, this is the first report of exfoliative dermatitis with a cephalosporin or related drug.

Topics: Aged; Cefoxitin; Dermatitis, Exfoliative; Diabetes Complications; Drug Eruptions; Foot Diseases; Humans; Male; Osteomyelitis; Skin Ulcer