Clinical experience with clindamycin hydrochloride: I. Treatment of streptococcal and mixed streptococcal-staphylococcal skin infections.

Two hundred and forty-four children were evaluated in a study comparing clindamycin hydrochloride, erythromycin, and phenoxymethyl penicillin for the treatment of streptococcal pyoderma. Similar numbers of patients were followed during (day 7) and after (day 14) therapy in each of the three treatment groups. All patients had skin lesions positive for group A streptococci with or without staphylococci; the percentage rate of pure and mixed cultures was similar for the three groups of patients. Both clindamycin and erythromycin proved somewhat superior to penicillin on the basis of effecting earlier clinical cures and sterilization of skin lesions. Streptococcal eradication rates by day 7 were as follows: clindamycin, 97%; erythromycin, 99%; and penicillin, 91%. By day 14, clinical and bacteriologic cure rates were essentially the same in each group: clindamycin, 99%; erythromycin, 99%; and penicillin, 97%. Persistence or reacquisition of a pyoderma strain in the upper respiratory tract was highest in that group treated with penicillin. There were no adverse reactions associated with clindamycin or the other antibiotic agents evaluated. However, clindamycin holds no advantage over erythromycin for treatment of streptococcal pyoderma, and additional clinical information will be required to determine whether the potential for toxicity in children will compromise the use of this newer antibiotic.