Clindamycin in the treatment of group G beta-haemolytic streptococcal infections.
We report a case of severe streptococcal cellulitis in a healthy 47 year old male, where the sole microbial isolate was a beta-haemolytic group G Streptococcus. Treatment failure with high dose penicillin was observed despite in vitro sensitivity. The addition of clindamycin resulted in dramatic clinical improvement. This may indicate an Eagle-type effect (whereby antibiotics exhibit paradoxically reduced bactericidal activities at high drug concentrations), in group G beta-haemolytic infections. Although well documented with group A streptococcal infections, this phenomenon has not been fully recognised with group G beta-haemolytic streptococcal infections. This may have important implications for clinical management.
Pillai
A
A
Dumfries and Galloway Royal Infirmary, Dumfries, DG1 4AP, UK.
Thomas
S
S
Williams
C
C
D000038:Abscess / Q000188:drug therapy* / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000032:analysis; D002481:Cellulitis / Q000188:drug therapy* / Q000382:microbiology; D002981:Clindamycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004890:Erythema / Q000473:pathology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D013291:Streptococcus / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D002097:C-Reactive Protein