A clinical trial of combination therapy with aztreonam and clindamycin in respiratory infections

• Published in: Japanese Journal of Chemotherapy Vol. 43; no. 2; pp. 213 - 221
• Main Author: Yamaguchi, Etsuro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 1995; 公益社団法人 日本化学療法学会
• Subjects: aztreonam; clindamycin; combination therapy; mycoplasma; pneumonia; respiratory infection
• ISSN: 1340-7007; 1884-5886
• DOI: 10.11250/chemotherapy1995.43.213

A clinical trial of a combination therapy with aztreonam (AZT) and clindamycin (CLDM) was carried at the First Department of Medicine, Hokkaido University School of Medicine, and its 17 affiliated hospitals to evaluate current usefulness of the therapy. The daily dose was, in general, 2.0g of AZT and 1.2g of CLDM, or 4.0g of AZT and 2.4g of CLDM (divided into two doses). The antibiotics were administered via drip infusion for 3 to 14 days. 1) The study subjects included 84 patients with bacterial pneumonia, 18 patients with mycoplasmal pneumonia, and 17 patients with miscellaneous respiratory infections. Side effects and abnormal laboratory findings were evaluated in all subjects, and clinical efficacy and usefulness in 114. 2) The clinical efficacy rates (excellent+good) in bacterial and mycoplasmal pneumonia were similar, 84.2% and 76.4%, respectively. The rate was 53.3% in other miscellaneous respiratory infections. The rate of excellent and good efficacy in all subjects were 20.2%(23/114) and 58.8%(67/114), respectively, and the overall efficacy rate was 79.0%. 3) Side effects were observed in 4.2%(5/119) of patients. There were 1 case of pseudomembranous colitis and 4 cases of eruption. Abnormal laboratory findings were observed in 20.2%(24/119) of patients. There were 2 cases of eosinophilia and 22 cases of mild to moderate abnormal hepatic enzyme values (14 cases of increased GOT, 20 cases of increased GPT). 4) The usefulness rates (very useful+useful) in bacterial pneumonia, mycoplasmal pneumonia, and other miscellaneous respiratory infections were 76.8%, 64.7%, and 53.3%, respectively. The overall usefulness rate was 71.9%. These findings demonstrated that combination therapy with AZT and CLDM for respiratory infections is still an effective therapeutic modality long after the development of these agents.