ROBERT J. FASS, M.D., F.A.C.P.; JOSEPH F. SCHOLAND, M.D.; GLENN R. HODGES, M.D.; SAMUEL SASLAW, M.D., Ph.D., F.A.C.P.
Nineteen adult patients with serious anaerobic infections were treated with 1.2 to 2.7 g/day of parenteral clindamycin. Five received aminoglycoside antibiotics concomitantly because of mixed infection with Gram-negative aerobic bacilli, and 15 underwent therapeutic surgical procedures. Cures were obtained in five patients with actinomycosis, four of five with pneumonia and empyema, one with a lung abscess, three with osteomyelitis, and five with abscesses or soft-tissue infections, or both; one patient with pneumonia and empyema relapsed when therapy was discontinued. The minimum inhibitory concentrations (MIC) of clindamycin for the patients' anaerobic isolates were 0.01 to 0.62 µg/ml. The serum concentrations of clindamycin were many times higher than the MIC of the clinical isolates from this study and the MIC of nearly all other anaerobic isolates previously reported in the literature. During therapy anaerobic pathogens could not be isolated, except from the single patient who subsequently relapsed. Clindamycin was well tolerated and generally nontoxic, although two patients developed rashes, necessitating its withdrawal. Clindamycin should be considered a primary antibiotic for the treatment of anaerobic infections.
FASS RJ, SCHOLAND JF, HODGES GR, SASLAW S. Clindamycin in the Treatment of Serious Anaerobic Infections. Ann Intern Med. ;78:853–859. doi: 10.7326/0003-4819-78-6-853
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Published: Ann Intern Med. 1973;78(6):853-859.
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