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[Antibacterial action of clindamycin in chronic, recurrent tonsillitis]
R Müller1, G Wichmann, E Haufe
1Klinik and Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikums Carl Gustav Carus der Technischen Universität Dresden.
Abstract:
After oral administration of 300 mg Sobelin, the efficacy and pharmacological kinetics of clindamycin (CAS 18323-44-9) were analysed in 35 patients with recurrent tonsillitis. Minimal inhibitor concentration (MIC) and minimal bactericidal concentration (MBC) have been evaluated for 120 strains. MIC and MBC for 91.7% of the strains amounted to 0.25 micrograms/ml. Concentrations of antibiotics in the serum were higher than 0.25 micrograms/ml after 12 h, i.e. higher than the minimal inhibitory concentration. The established free and efficient portion of clindamycin in the serum which is not bound to plasma proteins shows that a clear bacteriostatic effect is achieved up to 6 h after application of the antibiotic. The concentration in the tissue of the tonsils was 0.6-0.8 micrograms/g after 7-9 h indicating that sufficient MIC values were achieved. The free portion of the antibiotic in the tissues after 9 h also reached the MIC of germs. Hence clindamycin is considered to be an efficient antibiotic in the management of acute exacerbation of recurrent tonsillitis. Due to serum- and tissue levels of the tonsils administration of 300 mg of the test drug is indicated three times daily.
Insights
Clindamycin (CAS 18323-44-9) effectively treats recurrent tonsillitis by maintaining therapeutic antibiotic concentrations in serum and tonsil tissue. Dosing of 300 mg three times daily ensures sustained efficacy against bacterial strains.
Area of Science:
- Pharmacology
- Infectious Diseases
- Otolaryngology
Background:
- Recurrent tonsillitis poses a significant clinical challenge.
- Understanding antibiotic pharmacokinetics is crucial for effective treatment.
Purpose of the Study:
- To evaluate the efficacy and pharmacokinetic profile of clindamycin in patients with recurrent tonsillitis.
- To determine the optimal dosage regimen for clindamycin in this patient population.
Main Methods:
- Oral administration of 300 mg Sobelin (clindamycin) to 35 patients.
- Analysis of serum and tonsil tissue concentrations.
- Determination of Minimal Inhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) for 120 bacterial strains.
Main Results:
- Clindamycin achieved concentrations above MIC in serum for over 12 hours.
- Therapeutic concentrations in tonsil tissue (0.6-0.8 µg/g) were sustained for 7-9 hours.
- The free, unbound portion of clindamycin in serum and tissue demonstrated a bacteriostatic effect up to 6-9 hours post-administration.
Conclusions:
- Clindamycin (CAS 18323-44-9) is an effective antibiotic for managing acute exacerbations of recurrent tonsillitis.
- A dosage of 300 mg three times daily is indicated based on achieved serum and tonsil tissue levels.