Prophylaxis of streptococcal infections and rheumatic fever: a comparison of orally administered clindamycin and penicillin

Massell, Benedict F.

doi:10.1001/jama.241.15.1589

Cited by 32 publications

(9 citation statements)

References 14 publications

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“…No carriers of GABH S occurred among 100 children treated with lincomyein, whereas 12 carriers occurred among 102 children [15] recently reported a comparative study be tween clindamycin and penicillin in the pro phylaxis of streptococcal infections. Clind amycin was twice as effective as orally ad ministered penicillin for prophylaxis of strep tococcal infection with an antibody response.…”

Section: Discussionmentioning

confidence: 99%

The Treatment of the Carrier State of Group A Beta-Hemolytic Streptococci with Clindamycin

Brook¹,

Leyva²

1981

Chemotherapy

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20 children who were chronic carriers of group A beta-hemolytic streptococci (GABHS) were treated with oral clindamycin. Surface tonsillar cultures were obtained prior to therapy and 2 weeks after termination of therapy. They were processed for aerobic and anaerobic microorganisms. Mixed aerobic and anaerobic flora were obtained from all cultures. Prior to therapy, the average yield was 9 isolates (5 aerobes and 4.1 anaerobes) per specimen; after completion of therapy, the average yield was 5.7 isolates (3 aerobes and 2.7 anaerobes). GABHS, Staphylococcus aureus, Bacteroides fragilis,and Bacteroides oralis were completely eliminated after clindamycin therapy and the number of isolates of Bacteroides melaninogenicus and Fusobacterium sp. was reduced. Beta lactamase production was detected prior to therapy in 21 isolates recovered from 16 tonsillar surfaces (80%). These included all isolates of S. aureus (8) and B. fragilis (2), 8 of 18 B. melaninogenicus (44%), and 3 of 5 B. oralis (60%). Only one isolate of beta-lactamase-producing strain of B. melaninogenicus was recovered after conclusion of therapy. Follow-up of the patients for 18–24 months (average 22 months) showed no recurrence of GABHS in 19 of the 20 children.

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Section: Discussionmentioning

confidence: 99%

The Treatment of the Carrier State of Group A Beta-Hemolytic Streptococci with Clindamycin

Brook¹,

Leyva²

1981

Chemotherapy

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“…This therapeutic approach has been successful in recurrent tonsillitis [26,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]. Antimicrobials active against BLPB as well as GABHS were more effective than penicillin in the eradication of this infection.…”

Section: Therapeutic Implications Of Indirect Pathogenicitymentioning

confidence: 99%

“…Smith et al [26] illustrated the superiority of dicloxacillin therapy (50% success rate) compared with penicillin (17% success rate) in eradicating recurrent GABHS tonsillitis. Several studies demonstrated the efficacy of lincomycin [47][48][49][50] and clindamycin [51][52][53][54][55][56]61], the combination of penicillin plus rifampin over penicillin alone [57,58], and clindamycin over penicillin plus rifampin [59]. The superiority of these drugs compared with penicillin results from their efficacy against GABHS as well as AGNB and S. aureus.…”

Section: Therapeutic Implications Of Indirect Pathogenicitymentioning

confidence: 99%

β-Lactamase–Producing Bacteria in Upper Respiratory Tract Infections

Brook

2010

Curr Infect Dis Rep

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β-Lactamase-producing bacteria (BLPB) can play an important role in respiratory infections. They can have a direct pathogenic impact in causing the infection as well as an indirect effect through their ability to produce the enzyme β-lactamase. BLPB not only may survive penicillin therapy, but as demonstrated by in vitro and in vivo studies, can also protect other penicillin-susceptible bacteria from penicillin by releasing the free enzyme into their environment. The clinical in vitro and in vivo evidence supporting the role of these organisms in the increased failure rate of penicillin in eradication of these infections and the implication of that increased rate on the management of infections is discussed.

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“…The high failure rate of penicillin therapy associated with the recovery of BLPB from a growing number of cases of mixed aerobic-anaerobic infections highlights the importance of this therapeutic approach [21,22]. One infection for which this therapeutic approach has been successful is recurrent tonsillitis [26,[46][47][48][49][50][51][52][53][54][55][56][57][58][59]. Antimicrobial agents active against BLPB as well as GABHS were effective in the eradication of this infection.…”

Section: T H E R a P E U T I C I M P L I C A T I O N S O F I N D I R mentioning

confidence: 99%

β-Lactamase-producing bacteria in mixed infections

Brook

2004

Clinical Microbiology and Infection

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Beta-lactamase-producing bacteria (BLPB) can play an important role in polymicrobial infections. They can have a direct pathogenic impact in causing infections, as well as an indirect effect through their ability to produce the beta-lactamase. BLPB may not only survive penicillin therapy themselves, but can also protect other penicillin-susceptible bacteria from penicillin by releasing free beta-lactamase into their immediate environment. This phenomenon occurs in upper respiratory tract, skin, soft tissue, surgical and other infections. The in-vitro and in-vivo clinical evidence supporting the role of BLPB in the increasing failure of penicillin to resolve such infections, and the implications of this phenomenon for the management of infections, are discussed.

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Prophylaxis of streptococcal infections and rheumatic fever: a comparison of orally administered clindamycin and penicillin

Cited by 32 publications

References 14 publications

The Treatment of the Carrier State of Group A Beta-Hemolytic Streptococci with Clindamycin

The Treatment of the Carrier State of Group A Beta-Hemolytic Streptococci with Clindamycin

β-Lactamase–Producing Bacteria in Upper Respiratory Tract Infections

β-Lactamase-producing bacteria in mixed infections

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