Clindamycin in the treatment of group G β-haemolytic streptococcal infections

We report a case of severe streptococcal cellulitis in a healthy 47 year old male, where the sole microbial isolate was a β-haemolytic group G Streptococcus. Treatment failure with high dose penicillin was observed despite in vitro sensitivity. The addition of clindamycin resulted in dramatic clinical improvement. This may indicate an Eagle-type effect (whereby antibiotics exhibit paradoxically reduced bactericidal activities at high drug concentrations), in group G β-haemolytic infections. Although well documented with group A streptococcal infections, this phenomenon has not been fully recognised with group G β-haemolytic streptococcal infections. This may have important implications for clinical management.