![]() ![]() perfringens gas gangrene and in vitro in suppressing the α-toxin activity produced by that organism. 321 Clindamycin was more effective than penicillin in reducing mortality in a mouse model of C. perfringens, which is generally susceptible to this drug. Nevertheless, clindamycin may be preferable for treatment of this condition, 367 particularly in seriously ill patients and in those who have responded poorly to penicillin.Ĭlindamycin is useful as an alternative to penicillin in treatment of infections with C. 366 That study was problematic in that penicillin oral therapy was used to complete the course of treatment of some patients in the penicillin group. 365 Another similar study also demonstrated a higher failure rate with penicillin than with clindamycin and attributed it to penicillin-resistant anaerobes. ureolyticus, which are resistant to penicillin. melaninogenicus, Prevotella ruminicola, and B. 364 The study involved small numbers of patients and had some flaws in the analysis 365 however, the superiority of clindamycin for some patients was demonstrated and may relate to observations that 15% to 25% of anaerobic pulmonary infections involve β-lactamase–producing strains of B. In a prospective, randomized study of 39 patients with community-acquired putrid lung abscess, clindamycin was more effective than penicillin in the time until eradication of fever and fetid sputum and in the “overall response” to treatment. 361,362Ĭlindamycin may offer some advantage over penicillin G in the treatment of anaerobic bronchopulmonary infections 363 in addition, it may serve as an alternative in patients who are allergic to penicillin. ![]() fragilis or other penicillin-resistant anaerobic bacteria, it has lost favor as an empirical agent for polymicrobial intraabdominal infections. 360 While clindamycin has been known as an alternative choice for the treatment of infections outside of the central nervous system that are likely to involve B. 109Ĭlindamycin is largely used for gram-positive or anaerobic bacterial infections of the soft tissues, or both, though increasing resistance among pathogens has limited its utility. The lincosamides have been used in a variety of infections, often with good effect however, appreciation of the potential for serious or even fatal toxicity with pseudomembranous colitis and the availability of safer alternative antibiotics should now generally limit the use of clindamycin to a few indications as an alternative-choice antibiotic. The higher activity and absorption properties of clindamycin compared with lincomycin, along with no greater potential for toxicity, favor the former in all indications for use of these antibiotics. ![]() Bennett MD, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 2020 Uses of Clindamycin ![]()
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