Clindamycin resistance

The present study was conducted for detection of inducible resistance to Clindamycin in Staphylococcus aureus isolates using D – test at Raichur Institute of Medical Sciences-teaching hospital, RAICHUR, Karnataka, India.

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Nine Propionibacterium acnes (P. acnes) strains resistant to both clindamycin and erythromycin were selected to investigate the inhibitory ability of extracts and isolated compounds from leaves of Cassia grandis L.f to P. acnes. Ethyl acetate extract inhibited all P. acnes strains, with an aseptic ring diameter of 15-25 mm at a concentration of 200 mg/mL and a MIC value of 30 mg/mL.

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Streptococcal Toxic Shock Syndrome: Treatment In light of the possible role of pyrogenic exotoxins or other streptococcal toxins in streptococcal TSS, treatment with clindamycin has been advocated by some authorities (Table 130-3), who argue that, through its direct action on protein synthesis, clindamycin is more effective in rapidly terminating toxin production than penicillin—a cell-wall agent. Support for this view comes from studies of an experimental model of streptococcal myositis, in which mice given clindamycin had a higher rate of survival than those given penicillin.

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Inpatient Therapy Pneumococcal pneumonia is readily treatable with β-lactam antibiotics. The conventional dosages shown in Table 128-5 are acceptable against intermediately resistant strains and against many or most fully resistant isolates. Recommended agents include ceftriaxone and cefotaxime. Ampicillin is also widely used, usually in the form of ampicillin/sulbactam. The likely efficacy of newer quinolones such as moxifloxacin, macrolides such as azithromycin, and clindamycin is discussed above.

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Table 120-2 Selection of Antibiotics for Treatment of Acute Osteomyelitis Suggested Regimena Organism Primary Alternativesb Staphylococcus aureus Penicillin- Nafcillin or oxacillin, 2 g Cefazolin, 1 g IV resistant, methicillin- IV q4h q8h; ceftriaxone, 1 g IV q24h; clindamycin, 900 mg IV q8hc sensitive (MSSA) Penicillinsensitive Penicillin, 3–4 million U IV q4h Cefazolin, ceftriaxone, clindamycin (as above) Methicillinresistant (MRSA) Vancomycin, 15 mg/kg Clindamycinc (as IV q12h; rifampin, 300 mg PO above); linezolid, 600 q12h (see text) mg IV or PO q12hd; daptomycin,...

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