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Treatment of toxoplasmic encephalitis with intravenous clindamycin.
Arch Intern Med. 1988 Nov; 148(11):2477-82.AI

Abstract

At present, therapy for toxoplasmic encephalitis (TE) is the combination of pyrimethamine with sulfadiazine or trisulfapyrimidines. Unfortunately, due to adverse reactions to sulfonamides, many patients with acquired immunodeficiency syndrome (AIDS) are unable to receive a complete course of therapy. The promising results with clindamycin phosphate therapy in a mouse model of TE prompted us to seek further information about patients with AIDS with TE who had been treated with clindamycin. Fifteen such patients were identified in whom clindamycin was used to treat 18 episodes of TE. Eleven patients showed clinical or radiologic improvement after receiving clindamycin therapy, either alone or in combination with pyrimethamine. Twelve received oral clindamycin as suppressive therapy after discharge from the hospital. Adverse reactions possibly related to clindamycin therapy included diarrhea, reversible granulocytopenia, and skin reactions. The results of this retrospective study suggest that clindamycin, either alone or in combination with pyrimethamine, may represent an effective alternative therapy for TE in patients with AIDS. Whether this supposition can be substantiated by appropriately designed studies is presently being determined.

Authors+Show Affiliations

Department of Immunology and Infectious Diseases, Research Institute, Palo Alto, CA 94301.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

3190380

Citation

Dannemann, B R., et al. "Treatment of Toxoplasmic Encephalitis With Intravenous Clindamycin." Archives of Internal Medicine, vol. 148, no. 11, 1988, pp. 2477-82.
Dannemann BR, Israelski DM, Remington JS. Treatment of toxoplasmic encephalitis with intravenous clindamycin. Arch Intern Med. 1988;148(11):2477-82.
Dannemann, B. R., Israelski, D. M., & Remington, J. S. (1988). Treatment of toxoplasmic encephalitis with intravenous clindamycin. Archives of Internal Medicine, 148(11), 2477-82.
Dannemann BR, Israelski DM, Remington JS. Treatment of Toxoplasmic Encephalitis With Intravenous Clindamycin. Arch Intern Med. 1988;148(11):2477-82. PubMed PMID: 3190380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of toxoplasmic encephalitis with intravenous clindamycin. AU - Dannemann,B R, AU - Israelski,D M, AU - Remington,J S, PY - 1988/11/1/pubmed PY - 1988/11/1/medline PY - 1988/11/1/entrez SP - 2477 EP - 82 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 148 IS - 11 N2 - At present, therapy for toxoplasmic encephalitis (TE) is the combination of pyrimethamine with sulfadiazine or trisulfapyrimidines. Unfortunately, due to adverse reactions to sulfonamides, many patients with acquired immunodeficiency syndrome (AIDS) are unable to receive a complete course of therapy. The promising results with clindamycin phosphate therapy in a mouse model of TE prompted us to seek further information about patients with AIDS with TE who had been treated with clindamycin. Fifteen such patients were identified in whom clindamycin was used to treat 18 episodes of TE. Eleven patients showed clinical or radiologic improvement after receiving clindamycin therapy, either alone or in combination with pyrimethamine. Twelve received oral clindamycin as suppressive therapy after discharge from the hospital. Adverse reactions possibly related to clindamycin therapy included diarrhea, reversible granulocytopenia, and skin reactions. The results of this retrospective study suggest that clindamycin, either alone or in combination with pyrimethamine, may represent an effective alternative therapy for TE in patients with AIDS. Whether this supposition can be substantiated by appropriately designed studies is presently being determined. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/3190380/Treatment_of_toxoplasmic_encephalitis_with_intravenous_clindamycin_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/148/pg/2477 DB - PRIME DP - Unbound Medicine ER -