Management of infections caused by antibiotic-resistant streptococcus pneumoniae

To the Editor: In their timely review of the management of infections caused by antibiotic-resistant Streptococcus pneumoniae (Aug. 11 issue),¹ Friedland and McCracken omit mention of erythromycin and clindamycin as alternative therapy for penicillin-resistant pneumococcal pneumonia once susceptibility data are known. Table 1 of the article indicates that the incidence of resistance to penicillin in the United States is almost the same as the incidence of erythromycin resistance (7 percent and 6 percent, respectively). Recent data from the Centers for Disease Control and Prevention show a similar percentage of pneumococcal strains resistant to each antibiotic, but only 22 percent of.  . .