Clindamycin and cloxacillin compared in the treatment of skin and soft-tissue infections

The subjects were 61 patients with skin or soft-tissue infections treated at the Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. The patients, aged 15 to 59 years (40 females, 21 males), were randomly assigned to receive 300 mg of clindamycin or 500 mg of cloxacillin orally thrice daily for seven days. On day 8, the infections were cured in seven of the 31 clindamycin-treated patients and in three of the 30 cloxacillin-treated patients; on day 15, 27 of the clindamycin group and 18 of the cloxacillin group were cured; four clindamycin-treated patients and 11 cloxacillin-treated patients were improved; and one cloxacillin-treated patient failed. The between-group differences were not statistically significant. Pretreatment positive cultures were obtained in 40 patients, including Staphylococcus aureus in 24, group A beta-hemolytic streptococci in five, and a combination of S aureus and beta-hemolytic streptococci in four. Side effects were reported by three clindamycin-treated patients (gastric upset, nausea, and headache) and one cloxacillin-treated patient (nausea). Abnormal changes in laboratory test results from before to after treatment were noted in both patient groups and were probably not attributable to either drug. It is concluded that clindamycin is a safe and effective agent in the treatment of skin and soft-tissue infections.