Clindamycin Compared with Penicillin for the Treatment of Anaerobic Lung Abscess

Abstract

The clinical efficacy of clindamycin was compared with that of penicillin in a randomized study of the treatment of community-acquired putrid [bacterial] lung abscess. After starting therapy, patients treated with clindamycin had a shorter febrile period and fewer days of fetid sputum than patients treated with penicillin (mean 4.4 vs. 7.6 days and 4.2 vs. 8.0 days, respectively, P < 0.05). Four of 20 patients treated with penicillin had clinically significant pulmonary or pleural extension of their infection within 10 days after starting therapy; this was not found in any of 19 patients treated with clindamycin (P < 0.05). Penicillin treatment failed in 2 additional patients after 20 days of therapy. Within 1 mo. after treatment, 1 of 4 patients given penicillin for 3 wk had a relapse; of the 13 patients given clindamycin for 3 or 6 wk and 5 patients given penicillin for 6 wk, none had a relapse. Only 8 of 15 patients treated with penicillin who could be followed to the end of the study were cured; all 13 patients treated with clindamycin who could be followed were cured (P < 0.01). Evidently, penicillin is not the optimal therapy for anaerobic lung abscess.