Q: Why Clindamycin continue to be main stay of treatment for Necrotizing fasciitis?


Answer: In Necrotizing fasciitis, clindamycin continue to show superiority over other antibiotics. It remained part of all combination regimens due to it's antitoxin effects against toxin-elaborating strains of streptococci and staphylococci. Moreover, it can modulate the immune response.


 References:

1. Stevens DL, Gibbons AE, Bergstrom R, Winn V. The Eagle effect revisited: efficacy of clindamycin, erythromycin, and penicillin in the treatment of streptococcal myositis. J Infect Dis 1988; 158:23.

2. Zimbelman J, Palmer A, Todd J. Improved outcome of clindamycin compared with beta-lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Pediatr Infect Dis J 1999; 18:1096.

 3. Edlich RF, Winters KL, Woodard CR, Britt LD, Long WB 3rd. Massive soft tissue infections: necrotizing fasciitis and purpura fulminans. J Long Term Eff Med Implants. 2005. 15(1):57-65.