Severe GAS Infections — Are Clindamycin and IVIG “Out”?

A retrospective study involving 62 patients with invasive group A streptococcal infections showed no benefit from clindamycin or IVIG.

Invasive group A streptococcal (GAS) infections such as necrotizing fasciitis or streptococcal toxic shock syndrome (STSS) are increasingly common. These severe infections have high mortality even with prompt antimicrobial therapy. Traditional treatment recommendations include surgical debridement and a β-lactam. Clindamycin and high-dose intravenous immunoglobulin (IVIG) are often administered as well, although their use is not based on findings from large, well-designed studies.

Now, researchers have retrospectively analyzed all cases of invasive GAS infection that were treated in the intensive care unit of any of four Ontario hospitals from January 1992 through June 2002. Of the 62 patients, half suffered from underlying chronic diseases;…

Reviewing Author

Thomas Glück, MD