Urgent Notice For Podiatrists Regarding Foot Soak Prescription Medications

Urgent Notice For Podiatrists Regarding Foot Soak Prescription Medications


BlueChoice® and BlueCross learned of direct marketing campaigns for foot soaks used to treat foot disorders. Prescriptions are being written for medications that are traditionally used and indicated for administration orally, intravenously or through direct application. These prescription medications are not FDA-approved, nor generally medically necessary, when dispensed in a basin with water as a foot soak. Large numbers of prescriptions for the following medications are being issued: 

  • Gentamicin
  • Mupirocin
  • Oxiconazole Cream
  • Daptomycin
  • Voriconazole
  • Tobramycin
  • Doxycycline
  • Itraconazole
  • Econazole
  • Ketoconazole 2% Cream 
  • Erythromycin

BlueChoice’s and BlueCross’ Special Investigations Unit and Payment Integrity Teams are conducting medical record reviews that reveal instances where patients are advised to place these strong antibiotic prescription medications in foot basins with water as a foot soak. The use of these types of medications in such a foot soak would likely be considered not medically necessary.  

Medical record reviews have further indicated that the prescriptions are marketed as “innovative techniques, hydrotherapy and specialized anti-fungals.” In reality, these are prescriptions written for:  

  • 7,200 units of Clindamycin in a single script (120 bottles) 
  • 600 units of Gentamicin for a 15-day supply (120 bottles)
  • 900 units of Ketoconazole cream (30 tubes) 
  • 1,800 units of Erythromycin (30 tubes)  

The medicines are labeled for specific administration routes, such as topical, oral, IV or ophthalmologic. Dispensed quantities such as those listed above fall well outside of typical dosing, and practitioners should use caution if asked to sign blank prescription forms.  

Thank you for your assistance in addressing this matter.
Should you have any questions regarding this notice, or need to report questionable marketing activity, please call the Anti-Fraud Unit at 803-264-1407.