Clindamycin and Intravenous Immunoglobulin for Invasive Group A Streptococcal Infection: Is the Jury Still Out?

In a prospective, enhanced-surveillance study, the use of clindamycin with or without IVIG in patients with severe disease was associated with a nonsignificant mortality reduction.

In the management of invasive group A streptococcal (iGAS) infection, outstanding issues are whether adding clindamycin improves outcomes over β-lactam antibiotic alone, whether intravenous immunoglobulin (IVIG) further improves outcomes, and whether antibiotic prophylaxis for close contacts might be beneficial. Because iGAS is rare, a controlled trial examining these issues is unlikely to be achieved. Instead, investigators performed an active, prospective, enhanced-surveillance study in the state of Victoria, Australia, between March 1, 2002, and August 31, 2004, and found 333 patients whose condition met a case definition of iGAS, of whom 84 had severe disease. The authors also retrospectively collected data on household contacts for iGA…

Reviewing Author

Neil M. Ampel, MD

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Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Clindamycin and Intravenous Immunoglobulin for Invasive Group A Streptococcal Infection: Is the Jury Still Out?

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Reviewing Author