Clindamycin in the treatment of toxoplasmic retinochoroiditis.

We treated 26 patients with acute toxoplasmic retinochoroiditis with clindamycin between 1974 and 1982. Four patients were treated with clindamycin alone and 17 with clindamycin and prednisolone. Five patients received clindamycin and prednisolone, sulfadiazine, pyrimethamine, or cryocoagulation, or a combination of these. All patients with the acute disease had the characteristic foci and a positive titer on the Sabin-Feldman dye test of at least 1:16. Other causes of retinochoroiditis were excluded. All but two patients, who developed diarrhea after two weeks, received clindamycin for a minimum of three weeks. All patients improved after two weeks of treatment, but two patients with lesions larger than 2 disk diameters required an additional six weeks of treatment to heal completely. During follow-up periods ranging from 18 months to seven years (mean, three years) there have been only two recurrences (7.7%). Complications with clindamycin treatment were limited to gastrointestinal upsets, diarrhea, and skin rash. There were no cases of pseudomembranous colitis, the most serious reported complication of clindamycin use.