Clindamycin palmitate and
potassium phenoxymethyl penicillin were evaluated in 103 children with upper respiratory illnesses and pharyngeal group A streptococci, from November 1970 to July 1971. The children were assigned randomly by weight to one of the
antibiotic regimens given orally for 10 days.
Clindamycin palmitate and
potassium phenoxymethyl penicillin dosages were 75 and 125 mg, respectively, in 5 ml tid for children weighing less than 25 kg, and 150 and 250 mg, respectively, in 10 ml bid for children weighing 25 kg or more. Recurrences of the original streptococcal group A, M, and T types within 3 weeks after the end of treatment were classified as failures. The failure rates were:
clindamycin palmitate, 10% (5 of 52), and
potassium phenoxymethyl penicillin, 18% (9 of 51). Possible
drug-related rashes were observed in 8 of 52
clindamycin palmitate-treated patients. The geometric mean minimal inhibitory concentrations of
clindamycin and
penicillin against 103 isolates of group A streptococci were 0.033 and 0.007 mug/ml, respectively. The serum concentrations about 70 min after ingesting 150 mg of
clindamycin palmitate averaged 3.8 mug/ml and after 250 mg of
potassium phenoxymethyl penicillin averaged 0.9 mug/ml.
Clindamycin palmitate was as effective as
potassium phenoxymethyl penicillin in eradicating group A streptococci from the pharynx in tid and bid regimens. Nevertheless, because of its
rash-producing tendency in some patients and higher cost,
clindamycin palmitate should not be preferred to
penicillin for treatment of streptococcal
sore throat in the non-
penicillin-allergic patient.