Why Adding Clindamycin Is Important in Treating Group A Streptococcal Necrotizing Fasciitis

In an experimental model using mice and human tissue, therapeutic doses of clindamycin were found to inhibit key virulence factors in group A streptococci.

High-dose penicillin plus surgical debridement has been the standard therapy for necrotizing fasciitis caused by group A streptococci (GAS). Although adding clindamycin (CLI) is strongly recommended because of its ability to inhibit bacterial protein synthesis, this approach has never been tested in a prospective clinical trial, nor is such a trial feasible.

Now, Swiss and French investigators report the possible benefits of clindamycin therapy against GAS invasive infections with both CLI-susceptible and CLI-resistant isolates in an in vivo murine model and in tissue from a patient with GAS necrotizing fasciitis. In the mouse model, addition of therapeutic doses of clindamycin was associated with decreases in the virulence factors DNase and…

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)

Why Adding Clindamycin Is Important in Treating Group A Streptococcal Necrotizing Fasciitis

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Reviewing Author