Foote P A, Brook I
Division of Otorhinolaryngology, College of Medicine, University of Florida.
Arch Otolaryngol Head Neck Surg. 1989 Jul;115(7):856-9. doi: 10.1001/archotol.1989.01860310094031.
Fifty patients, scheduled for an elective tonsillectomy because of recurrent group A beta-hemolytic streptococcal tonsillitis, participated in a prospective randomized study that compared the efficacy of presurgical treatment with either phenoxymethyl penicillin or clindamycin hydrochloride in eradicating group A beta-hemolytic streptococci and beta-lactamase-producing bacteria (BLPB) from the tonsillar core. They were randomized into three groups as follows: 11 received penicillin, 22 received clindamycin, and 17 received no therapy. Group A beta-hemolytic streptococci were isolated from 8 (40%) of 17 untreated patients, 4 (36%) of 11 patients treated with penicillin, and none of 22 patients treated with clindamycin. Twenty-one BLPB were isolated from 16 (94%) of 17 untreated patients, 11 BLPB from 9 (82%) of 11 patients treated with penicillin, and 7 BLPB from 7 (32%) of 22 patients treated with clindamycin compared with penicillin or no therapy. Of the 22 patients treated with clindamycin, 10 were younger than 12 years of age. The BLPB were eradicated in nine patients (90%). However, BLPB were eradicated only in 6 (50%) of the 12 patients who were aged 13 years and older. These data illustrate the efficacy of clindamycin therapy in eradicating group A beta-hemolytic streptococci, as well as BLPB, in recurrent inflamed tonsils, especially in persons aged 12 years old and younger.
50名因复发性A组β溶血性链球菌扁桃体炎而计划接受择期扁桃体切除术的患者参与了一项前瞻性随机研究，该研究比较了术前使用苯氧甲基青霉素或盐酸克林霉素根除扁桃体隐窝内A组β溶血性链球菌和产β-内酰胺酶细菌（BLPB）的疗效。他们被随机分为三组：11人接受青霉素治疗，22人接受克林霉素治疗，17人未接受治疗。17名未治疗患者中有8名（40%）分离出A组β溶血性链球菌，11名接受青霉素治疗的患者中有4名（36%）分离出该菌，而22名接受克林霉素治疗的患者中无一例分离出该菌。17名未治疗患者中有16名（94%）分离出21株BLPB，11名接受青霉素治疗的患者中有9名（82%）分离出11株BLPB，与青霉素治疗组或未治疗组相比，22名接受克林霉素治疗的患者中有7名（32%）分离出7株BLPB。在22名接受克林霉素治疗的患者中，10名年龄小于12岁。9名患者（90%）的BLPB被根除。然而，在13岁及以上的12名患者中，只有6名（50%）的BLPB被根除。这些数据表明，克林霉素治疗在根除复发性发炎扁桃体中的A组β溶血性链球菌以及BLPB方面具有疗效，尤其是在12岁及以下的人群中。
