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Previous studies using mouse models ofStreptococcus pyogenes necrotizing fasciitis demonstrated that clindamycin had greater efficacy than penicillin. Frequently both agents are used concurrently in the treatment of severeS. pyogenes infections. This study investigated interactions between penicillin and clindamycin. E-test and broth microdilution assays suggested additivity or indifference, while timed-killing assays demonstrated concentration-dependent variable effects. Timed-kill studies utilizing clinical concentrations suggest that there is no antagonism with the combination of drugs but that the combination does not have a bactericidal advantage over either penicillin or clindamycin alone.

In Vitro Antimicrobial Effects of Various Combinations of Penicillin and Clindamycin against Four Strains of Streptococcus pyogenes