Clindamycin vs Penicillin for Anaerobic Lung Infections: High Rate of Penicillin Failures Associated With Penicillin-Resistant Bacteroides melaninogenicus

摘要: • Thirty-seven adult patients with anaerobic lung infections (27 abscesses and 10 necrotizing pneumonias) were submitted to transthoracic needle aspiration and/or bronchoscopic specimen brush cultures before therapy thereafter in all cases considered be failures. Patients randomly assigned receive either clindamycin, 600 mg intravenously every 6 hours, or penicillin G, 2 million U 4 hours for no less than 8 days, until clinical radiological improvement became apparent. Treatment was continued orally 300 V, 750 completing a minimum of weeks. Ten the 47 anaerobes initially isolated from (nine Bacteroides melaninogenicus one capillosus) resistant penicillin, but none clindamycin. Five nine harboring these penicillin-resistant received failed respond therapy. Overall, eight 18 group 19 clindamycin These drugs equally well tolerated both groups. The presence is frequent cause failure infections. In this setting, appears current choice initial treatment. (Arch Intern Med. 1990;150:2525-2529)