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.
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