CLINDAMYCIN IN RECURRENT GROUP-A STREPTOCOCCAL PHARYNGSTONSILLITIS - AN ALTERNATIVE TO TONSILLECTOMY

Fifty-three patients with bacterial treatment Failure after a 10-day c ourse of treatment with phenoxymethyl penicillin (pcV) for group A str eptococcal (GAS) pharyngotonsillitis were randomly assigned to continu ed treatment with pcV, or to treatment with clindamycin instead. The p atients were then followed for 1 year with throat cultures and clinica l examination every third month and in the event of symptoms of sore t hroat. In the first 3-month period, 15/22 patients in the pcV group yi elded one or more positive cultures for GAS, all of the same T-type as in the original throat culture. as compared to 3/26 in the clindamyci n group (p < 0.001). All three cases in the clindamycin group were due to a new T-type and thus were re-infections. In the pcV group, owing to repeated treatment failure, 12/22 patients were switched to treatme nt with clindamycin within the 3-month period following the second tre atment. During the remainder of the I-year follow-up period, sporadic cases of GAS-positive throat cultures occurred in both groups, but the re was no significant difference in frequency between the two groups. It is concluded that, in patients with GAS pharyngotonsillitis and fai lure after pcV treatment, a 10-day course of clindamycin can protect t he patient from recurrence for at least 3 months and might be an alter native to tonsillectomy.