Treatment of diabetic foot infection: An open randomised comparison of imipenem/cilastatin and piperacillin/clindamycin combination therapy

K. Paul Bouter*, Frank L.J. Visseren, Ruud M.M. Van Loenhout, Anton K.M. Bartelink, D. Willem Erkelens, Rob J.A. Diepersloot

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)

Abstract

Objective: To compare the clinical outcome and bacteriological response in diabetic patients with a foot infection treated with imipenem/cilastatin or a combination of piperacillin/clindamycin. Methods: Patients hospitalised for diabetic foot lesions Wagner Stages II, III or IV were randomly assigned to receive either imipenem/cilastatin 500 mg QID or piperacillin 3000 mg QID in combination with clindamycin 600 mg TID. Cultures were obtained and clinical observations were made. Results: Forty-six patients (mean age 71.4 ± 9.8 years) entered the study, 22 received imipenem/cilastatin (IC) and 24 received piperacillin/clindamycin (PCL) combination therapy. In the IC group 22.2% was considered to be clinically cured, 76.2% improved. In the PCL group this was 25.0% and 50.0%, respectively. In the IC treatment group 45.0% of baseline pathogens was eradicated compared to 70.0% in the PCL group. Adverse events were more often reported in PCL treated patients (50.0% vs. 19.0% P < 0.05). Conclusions: Imipenem/cilastatin and piperacillin/clindamycin combination therapy were equally effective in the treatment of patients with diabetic foot lesions. The imipenem/cilastatin regimen caused less side effects.

Original languageEnglish
Pages (from-to)143-147
Number of pages5
JournalInternational Journal of Antimicrobial Agents
Volume7
Issue number2
DOIs
Publication statusPublished - 1 Jan 1996

Keywords

  • Antibiotic therapy
  • Clinical trial
  • Diabetic foot

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