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Antimicrob Agents Chemother. 1977 April; 11(4): 695-697
Copyright © 1977 American Society for Microbiology. All Rights Reserved.

Susceptibility of Clostridium perfringens Isolated from Human Infections to Twenty Antibiotics

^* Departments of Pathology and Medicine, University of Colorado Medical Center, Denver, Colorado 80262
Veterans Administration Hospital, Denver, Colorado 80220

ABSTRACT

The proper choice of antibiotic for Clostridium perfringens infections in patients allergic to penicillin is not clear; the usual recommendations and recent in vitro studies disagree. We tested the susceptibility of 57 strains of C. perfringens to eight penicillins, seven cephalosporins, two tetracyclines, clindamycin, chloramphenicol, and rifampin by the agar dilution method. All strains were inhibited by (per milliliter) 4 µg or less of any of the penicillins, chloramphenicol, or clindamycin and 8 µg or less of any of the cephalosporins tested. Penicillin G and amoxicillin inhibited all strains at 0.12 µg or less per ml. Only 54% of the strains were inhibited by 1 µg of tetracycline per ml. Penicillin G remains the drug of first choice for infections with C. perfringens; it need not be added to a regimen containing a penicillinase-resistant penicillin given parenterally in high doses. The cephalosporins should be considered as alternative drugs for penicillin-allergic patients. Clindamycin and chloramphenicol are also effective. Tetracyclines cannot be depended upon in clostridial infections without in vitro testing, which is impracticable for initial empirical therapy.