Clindamycin in treatment of aspiration pneumonia in children.

Twenty-eight patients with anaerobic pleuropulmonary infections were treated with clindamycin alone or clindamycin with gentamicin. Sixteen of the patients presented with pneumonitis, nine with necrotizing pneumonia, and three with lung abscesses. The average length of treatment was 13.8 days, and the duration of temperature after initiation of therapy was 3.1 days. The predominant isolates were anaerobic gram-positive cocci (23 isolates), Bacteroides melaninogenicus (14), Bacteroides fragilis (9), and Fusobacterium nucleatum (11). The most frequent aerobic isolates were alpha-hemolytic streptococci (12), Diplococcus pneumoniae (12), Pseudomonas aeruginosa (9), Klebsiella pneumoniae (7), group A beta-hemolytic streptococci (5), Staphylococcus aureus (9), and Escherichia coli (6). All patients responded to the therapy and were cured of the infection. There were no side effects observed from the administration of clindamycin. None of the patients developed any blood dyscrasia, liver damage, diarrhea, or colitis. Clindamycin appears to be effective in the treatment of mixed aerobic and anaerobic pleuropulmonary infections in children, alone or with an aminoglycoside when indicated.