Clindamycin, metronidazole, and chloramphenicol are three antimicrobial agents useful
in the treatment of anaerobic infections. Clindamycin is effective in the treatment
of most infections involving anaerobes and gram-positive cocci, but emerging resistance
has become a problem in some clinical settings. Metronidazole is effective in the
treatment of infections involving gram-negative anaerobes, but it is unreliable in
the treatment of gram-positive anaerobic infections and is ineffective in treating
aerobic infections. Additionally, metronidazole is often the drug of choice in treating
infections in which Bacteroides fragilis is a serious concern. Chloramphenicol is effective in the treatment of a wide variety
of bacterial infections, including serious anaerobic infections, but is rarely used
in Western countries because of concerns about toxicity, including aplastic anemia
and gray baby syndrome.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Mayo Clinic ProceedingsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Lincomycin. a new antibiotic. I. Discovery and biological properties.Antimicrob Agents Chemother. 1962; 1963: 554-559
- In vitro and in vivo evaluation of lincomycin. a new antibiotic.Antimicrob Agents Chemother 1962. 1963; : 570-582
- Comparative studies of antibacterial activity in vitro and absorption and excretion of lincomycin and clinimycin.Am J Med Sci. 1968; 256: 279-292
- Antimicrobial agents: tetracyclines, chloramphenicol, erythromyein, and miscellaneous antibacterial agents.in: Gilman AG Goodman LS Rall TW Murad F Goodman and Gilman's The Pharmacological Basis ol Therapeutics. 7th ed. Macmillan, New York1985: 1179-1191
- Lincomycin, an inhibitor of aminoacyl sRNA binding to ribosomes.Proc Vat Acad Sci U S A. 1966; 55: 431-438
- Macrolides and clindamycin.in: Mandell GL Bennett JE Dolin R 4th ed. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. Vol 1. Churchill Livingstone, New York1995: 334-347
- Potentiation of opsonization and phagocytosis of Streptococcus pyogenes following growth in the presence of clindamycin.J Clin Invest. 1981; 67: 1249-1256
- Clindamycin levels in various body tissues and fluids.J Clin Pharmacol New Drugs. 1972; 12: 259-262
- Clindamycin uptake by human neutrophils.J Infect Dis. 1981; 144: 472-479
- Effect of clindamycin prophylaxis on the colonie microflora in patients undergoing colorectal surgery.Antimicrob Agents Chemother. 1981; 20: 736-740
- Anaerobic bacteria: general concepts.in: Mandell GL Bennett JE Dolin R 4th ed. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. Vol 2. Churchill Livingstone, New York1995: 2156-2173
- Bacteroides, Porphyromonas. Prevotella, Fusobacterium, and other anaerobic gram-negative bacteria.in: Murray PR Baron EJ Pfaller MA Tenover FC Yolken RH Manual of Clinical Microbiology. 6th ed. ASM Press, Washington (DC)1995: 603-620
- Gorbach SL Clindamycin and metronidazole.Med Clin North Am. 1995 Jul; 79: 84-367
- Susceptibility of the Bacteroides fragilis group in the United States: analysis by site of isolation.Antimicrob Agents Chemother. 1988; 32: 717-722
- Epidemiology, antimi crobial susceptibility, pathogenicity, and significance of Bacteroides fragilis group organisms isolated at Los Angeles County-University of Southern California Medical Center.Rev Infect Dis. 1991; 13: 12-18
- Variation in the susceptibility of Bacteroides fragilis group isolates from six Chicago hospitals.Chn Infect Dis. 1993; 16: S357-S360
- Resistance of Staphylococ-cus aureus to lincomycin. clinimycin, and erythromyein.Antimicrob Agents Chemother. 1968-1969; : 392-397
- Clindarnycin in the treatment of serious anaerobic infections.Ann Intern Med. 1973; 78: 853-859
- Clindarnycin compared with penicillin for the treatment of anaerobic lung abscess.Ann Intern Med. 1983; 98: 466-471
- Treatment of aspiration pneumonia and primary lung abscess: penicillin G vs clindarnycin.JAMA. 1975; 234: 935-937
- Clindarnycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis: a prospective double-blind clinical trial.South Med J. 1992; 85: 1077-1080
- Treatment of bacterial vaginosis: a comparison of oral metronidazole, metronidazole vaginal gel. and clindarnycin vaginal cream.J Fam Pract. 1995; 41: 443-449
- A double blind comparison of topical clindarnycin and oral minocycline in the treat ment of acnevulgaris.Acta Oerm Venereol. 1990; 70: 534-537
- A comparative study of benzoyl peroxide and clindamycin phosphate for treating acnevulgaris.BrJDermatol. 1988; 119: 615-622
- Treatment of rosacea: topical clindamycin versus oral tetracycline.Int J Dermalel. 1993; 32: 65-67
- Pseudomembranous colitis caused by topical clindamycin phosphate.Arch Dermatol. 1986; 122: 583-584
- Clostridium difficile: history of its role as an enteric pathogen and the current state of knowledge about the organism.Clin Infect Dis. 1994; 18: S265-S272
- Clostridium difficile colitis: an efficient clinical approach to diagnosis.Ann Intern Med. 1995; 123: 835-840
- Clindamycin: a review of fifteen years of experience.Rev Infect Dis. 1982; 4: 11331153
- Clindamycin: clinical and laboratory evaluation of parenteral therapy.Am J Med Sei. 1972; 263: 368-382
- Gastrointestinal side effects associated with clindamycin: 1.000 consecutive patients.Arch Intern Med. 1976; 136: 876-879
- Prolongation of a pancuronium-induced neuromuscular blockade by clindamycin.Anestnesiology. 1974; 41: 407-408
- Tables of antimicrobial agent pharmacotogy.in: Mandell GL Bennett JE Dohn R 4th ed. Manuell. Douglas and Bennetts Principles and Practice of Infectious Diseases. Vol 1. Churchill Livingstone, New York1995: 492-528
- Metronidazole.in: Mandell GL Bennett JE Dolin R 4th ed. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. Vol 1. Churchill Livingstone, New York1995: 329-334
- Tetracyclines and chloramphenicol.in: Mandell GL Bennett JE Dolin R 4th ed. Mandell, Douglas and Bennett's Principles and Practice ot infectious Diseases. Vol 1. Churchill Livingstone, New York1995: 306-317
- Chloramphenicol: a review of its use in clinical practice.Rev Infect Dis. 1981; 3: 479-491
- McEvoy GK Litvak K Welsh Jr, OH American Hospital Formulary Service Drug Information. American Society of Health-System Pharmacists, Bethesda (MD)1995: 360-361
- Prevention of bacterial endocarditis: recommendations by the American Heart Association.JAMA. 1997; 277: 1794-1801
- Metronidazole.Johns Hopkins Med J. 1981; 149: 89-92
- Metronidazole: in vitro activity, pharmacology and efficacy in anaerobic bacterial infections.Pharmacotherapy. 1981; 1: 28-38
- Metronidazole |published erratum appears in Infect Control 1987:8:48).Infect Control. 1986; 7: 514-518
- Systemic concentrations of metronidazole and its main metabolites after intravenous, oral and vaginal administration.Gynecot Obstet invest. 1987; 24: 200-207
- Metronidazole.Ann Intern Med. 1980; 93: 585-587
- In vitro susceptibility of anaerobic and microaerophilic bacteria to metronidazole and its hydroxy metabolite.in: Finegold SM George WL Rolfe RD First United States Metronidazole Conference. Biomedical Information, New York1982: 61-66
- Clinical pharmacokinetics of metronidazole and other nitroimidazole anti-tnfectives.Clin Pharmacokinet. 1992; 23: 328-364
- Rote of the reference laboratory in susceptibility testing of anaerobes and a survey of isolates referred from laboratories in England and Wales during 1993-1994.Clin Infect Dis. 1995; 20: S180-S186
- Antimicrobial resistance in Bacteroides.Clin Infect Dis. 1993; 16: S390-S400
- Bacteroides fragilis resistant to metronidazole after long-term therapy [letter].Lancet. 1978; 1: 214
- Analysis of trends in antimicrobial resistance patterns among clinical isolates of Bacteroides fragilis group spe cies from 1990 to 1994.Clin Infect Dis. 1996; 23: S54-S65
- Antimicrobial susceptibilities Df anaerobic bacteria isolated at the Mayo Clinic during 1982 through 1987: comparison with results from 1977 through 1981.Mayo Clin Proc. 1989; 64: 392-399
- Metronidazole.Mayo Clin Proc. 1983; 58: 154-157
- Metronidazole vs clindamycin treatment of anaerobic pulmonary infection: failure of metronidazole therapy.Arch Intern Med. 1981; 141: 1424-1427
- Metronidazole in the treatment of anaerobic infections.Am Rev Respir Dis. 1979; 120: 337-343
- Treatment of Clostridium difficile colitis [editorial].Gastroenterology. 1985; 89: 1192-1194
- Prospective randomised trial of metronidazole versus vancomycin for Ctostridium-difficiVe-associated diarrhoea and colitis.Lancet. 1983; 2: 1043-1046
- Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile-associated diarrhea [published erratum appears in Clin Infect Dis 1996:23:423].Clin Infect Dis. 1996; 22: 813318
- Antibiotic-associated colitis.in: Mandell GL Bennett JE Dolin R 4th ed. Mandell Douglas and Bennett's Principles and Practice of Infectious Diseases. Vol l. Churchill Livingstone, New York1995: 978-987
- Bacterial vaginosis.Clin Obstet Gynecol. 1993; 36: 166176
- Reduced incidence of preterm delivery with metronidazole and eryth romycin in women with bacterial vaginosis.N Engl J Med. 1995; 333: 1732-1736
- The treatment of Heltcobacter pylori infection in the management of peptic ulcer disease.N Engl J Med. 1995; 333: 984-991
- Antimicrobial treatment of Helicobacter pylori infection.Clin Infect Dis. 1997; 25: 1023-1026
- Omeprazole enhances efficacy of triple therapy in eradicating Helicobacter pylori.Gut. 1995; 37: 477-481
- Healing of perineal Crohn's disease with metronidazole.Gastroenterology. 1980; 79: 357-365
- Infections of the oral cavity, neck, and head.in: Mandell GL Bennett JE Dolin R 4th ed. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. Vol. 1. Churchill Livingstone, New York1995: 593-606
- Diagnosis and management of HlV-assooiated periodontal lesions.J Am Dent Assoc. 1989; 119: Suppl-Su24S
- Metronidazole treatment in rosacea.Int J Dermatol. 1988; 27: 1-5
- A critical appraisal of the toxicology of metronidazole.in: Phillips I Collier J Metronidazole. Royal Society of Medicine, London1979: 215-222
- Colitis associated with metronidazole therapy.J Infect Dis. 1980; 141: 772-774
- Metronidazole-induced pancreatitis.Am J Gastroenterol. 1989; 84: 958-960
- Metronidazole induced acute pancreatitis.Rev Infect Dis. 1991; 13: 1213-1215
- Sudden death due to metro-nidazole/ethanol interaction.Am J Forensic Med Pathol. 1996; 17: 343-346
- A significant interaction between metronidazole and warfarin.Mayo Clin Proc. 1976; 51: 782-784
- Mutagenicity of metronidazole: activation by mammalian liver microsomes.Biochem Biophys Res Commun. 1975; 66: 520-525
- Detection of carcinogens as mutagens in the Salmonella/microsome test: assay of 300 chemicals.Proc Natl Acad Sei US A. 1976; 73: 950954
- Induction of lung tumors and malignant lymphomas in mice by metronidazole.J Natl Cancer Inst. 1972; 48: 721-729
- Experimental induction of hepatomas, mammary tumors, and other tumors with metronidazole in non-inbred Sas:MRC(W1)BR rats.J Natl Cancer Inst. 1979; 63: 863-868
- Metronidazole use in obstetrics and gynecol-ogy: a review.Am J Obstet Gynecol. 1983; 145: 865-881
- Drug prescribing in renal failure: dosing guidelines for adults.Am J Kidney Dis. 1983; 3: 155-193
- Pharma-cokinetics of metronidazole in patients undergoing continuous ambulatory peritoneal dialysis.Antimicrob Agents Chemother. 1984; 25: 306-310
- Pharmacokinetics of metronidazole in patients with alcoholic liver disease.Antimicrob Agents Chemother. 1987; 31: 1662-1664
- Metronidazole pharma cokinetics in patients with hepatic encephalopathy.Scand J Castro-enterot. 1987; 22: 117-123
- Chlormycetin, a new antibiotic from a soil actinomycete.Science. 1947; 106: 417
- Metabolism of chloramphenicol: a story of nearly 50 years.Drug Metab Rev. 1994; 26: 767-783
- Saint or sinner? A look at chloramphenicol.P NG Med J. 1992; 35: 210-216
- Inhibitors of ribosome function.Ann Rev Microbiol. 1971; 25: 487-562
- Identification of chloramphenicol binding protein in Escherichia coli rihosomes by affinity labeling.Proc Natl Acad Sei U S A. 1973; 70: 2229-2233
- Recovery of poysome function of T4-infected Escrrericfria coli after brief treatment with chloramphenicol and rifampin.Antimicrob Agents Chemother. 1975; 7: 549-554
- Bactericidal and bacteriostatic action of chloramphenicol against meningeal pathogens.Antimicrob Agents Chemother. 1979; 16: 13-18
- Clinician's guide to antibiotics: chloramphenicol.BrJHospMed. 1988; 39: 424-428
- Biochemical studies on chloramphenicol (chlormycetin): tissue distribution and excretion studies.J Pharmacol Exp Ther. 1949; 96: 445-459
- Nosocomial infections with vancornycïn-resistant Enterococcus faecium in liver transplant recipients: risk factors for acquisition and mortality.Clin Infect Ois. 1996; 23: 760-766
- Statewide study of chloramphenicol therapy and fatal aplastic ane mia.JAMA. 1969; 208: 2045-2050
- Aplastic anemia after parenteral chloramphenicol: warning renewed [letter].N Engt J Med. 1982; 306: 1486
- Systemic reactions to ophthalmic drug preparations.Med Toxicol. 1987; 2: 287-293
- A controlled double-blind study of the hématologie toxicity of chloramphenicol.N EngUMed. 1965; 272: 1137-1142
- Chloramphenicol toxicity in liver and renal disease.Aren Intern Med. 1963; 112: 161-168
- Chloramphenicol in the newborn infant: a physiologic explanation of its toxicity when given in excessive doses.N EngUMed. 1960; 262: 787-794
- The “grey toddler”: chloramphenicol toxicity.Arch Dis Child. 1974; 49: 235-237
- Overdoses of chloramphenicol [letter].JAMA. 1975; 234: 149-150
- Neurotoxic reaction to ehloromycetin.Ann Intern Med. 1952; 36: 1526-1528
- Chloramphenicol toxicity.Adverse Drug React Toxicol Rev. 1993 Summer; 12: 83-95
- Inhibition of drug metabolism by chloramphenicol.Lancet. 1969; 2: 1397-1399
- Drugs affecting therapy with anticoagulants.Med Clin North Am. 1972 Jan; 56: 255-262
- Vitamin K deficiency associated with prolonged antibiotic administration.Arch intern Med. 1957; 100: 986-988
- The pharmacokinetics of chloramphenicol in the neonate and young infant.J Antimicrob Chemother. 1983; 12: 629-639
Article Info
Identification
Copyright
© 1999 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
