Hinthorn D R, Baker L H, Romig D A, Voth D W, Liu C
South Med J. 1977 Jul;70(7):823-6. doi: 10.1097/00007611-197707000-00018.
Clindamycin was used to treat six patients with endocarditis because of allergy to penicillin in five, and an unfavorable clinical response to methicillin in one. Only one patient had an uneventful cure with clindamycin. Two had hepatotoxicity which resolved rapidly after clindamycin was stopped. Two patients, one of whom had an aortic prosthesis, had completed four to six weeks of clindamycin therapy when clinical relapse occurred and blood cultures were again positive for a clindamycin-sensitive isolate. A fifth patient had peptostreptococcal endocarditis. Despite a favorable initial clinical and bacteriologic response, blood cultures taken on the 20th day of therapy again grew the Peptostreptococcus. This relapse pathogen had become resistant to clindamycin and was 100-fold less sensitive than the initial isolate. The few conditions in which clindamycin is indicated for therapy of bacterial endocarditis are outlined.
由于五例对青霉素过敏，一例对甲氧西林临床反应不佳，因此使用克林霉素治疗六例心内膜炎患者。仅一例患者使用克林霉素后顺利治愈。两例出现肝毒性，在停用克林霉素后迅速缓解。两名患者（其中一名有主动脉假体）在完成四至六周的克林霉素治疗后出现临床复发，血培养再次对克林霉素敏感菌株呈阳性。第五例患者患有消化链球菌心内膜炎。尽管初始临床和细菌学反应良好，但在治疗第20天采集的血培养物中再次培养出消化链球菌。这种复发病原体已对克林霉素耐药，其敏感性比初始分离株低100倍。文中概述了克林霉素用于治疗细菌性心内膜炎的少数适用情况。
