Abstract
Clindamycin-2-palmitate (CLDM-P), an analogue of clindamycin devised for the pediatric use, was employed for the treatment of pediatric surgical infections, and in vivo and in vitro studies were made with the following results.
1. Absorption and excretion
With the initial oral dose of 4.0 mg/kg to an infant of two months, the blood level attained the peak of 5.4 mcg/ml at 4 hour, and at 6 hour the drug was still detected at the level of 3.4 mcg/ml. In the same patient, at a certain point of a series of CLDM-P treatments, a lymph level of 4.8 mcg/ml was detected 2.5 hours after the administration of oral 4.0 mg/kg (concurrently determined blood level was 6.3 mcg/ml). Urinary recovery in 5 hours after the initial oral dose of 4.0 mg/kg in a 6-year-old patient was only 1.1 mg (0.7%), indicating a slow excretion rate.
2. Antibacterial spectrum
When CLDM HCI was used, the minimum inhibitory concentrations against 81% of 25 clinically isolated strains of Staphylococcus aureus were <0.2 mcg/ml.
In the case of CLDM-P, almost all of these strains were resistant to this drug.
3. Clinical results
Twenty-four pediatric patients with furuncle, abscess, cellulitis, lymphonoditis or suspected postoperative endocarditis, or for postoperative prophylaxis, were treated with CLDM-P, 1/3 or 1/4 dose of 8.3-50 mg/kg, 3 or 4 times a day. The response to the therapy was excellent in 6 cases, good in 15, fair in 2 and nil in 1. As untoward effects, diarrhea and anorexia were observed in one patient, and diarrhea in one.
