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November 26, 1973

Pneumococcal Endocarditis Treated with Clindamycin

Author Affiliations

Veterans Administration Center Medical College of Wisconsin Wood (Milwaukee)

JAMA. 1973;226(9):1120-1121. doi:10.1001/jama.1973.03230090044019

To the Editor.—  Penicillin is well established as the treatment of choice for pneumococcal endocarditis. Patients with penicillin allergy may be desensitized to the drug, treated concomitantly with penicillin and an adrenal corticosteroid, or given an alternative antibiotic.1 The first two forms of therapy have an attendant risk of anaphylaxis. Clindamycin is a semisynthetic derivative of lincomycin that has bacteriocidal activity against many Gram-positive cocci and has been used successfully in the treatment of staphylococcal endocarditis.2 This report describes the results of the treatment of pneumococcal endocarditis with clindamycin.

Report of a Case.—  A 48-year-old man was admitted with a one-week history of malaise, fever, and pain in the left wrist. The temperature was 39.5 C. A soft systolic murmur was heard along the left sternal border, and the left wrist was slightly swollen and tender. Pertinent laboratory studies disclosed the following values: hemoglobin, 10.0 gm/100 ml; hematocrit