Clindamycin in the Treatment of Streptococcal and Staphylococcal Toxic Shock Syndromes

OBJECTIVE: To evaluate the utility of clindamycin in the treatment of streptococcal and staphylococcal toxic shock syndromes. DATA SOURCES: Biomedical literature was accessed through MEDLINE (1966–December 1999). Key terms included clindamycin, streptococcal toxic shock, and staphylococcal toxic shock. DATA SYNTHESIS: Streptococcal and staphylococcal toxic shock syndromes are associated with a high mortality rate. β-Lactams have been considered the drug of choice for the treatment of these serious infections, with the occasional use of adjunctive clindamycin, although no clinical evidence has been published to support this latter regimen. An evaluation of the information to propose the usefulness of clindamycin was conducted. CONCLUSIONS: Experimental laboratory evidence suggests utility of the adjunctive use of clindamycin in streptococcal and staphylococcal infections complicated by toxin production. Research using animal models comparing clindamycin plus β-lactams with β-lactams alone for the treatment of these infections would be useful.