To the Editor.—
The article by Goldstein et al (242:435, 1979) regarding the antibiotic therapy of anaerobic pleuropulmonary and soft-tissue infections indicated that erythromycin was a "reasonable alternative" to penicillin in the treatment of penicillin-allergic patients with anaerobic pulmonary infections. The majority of their patients with favorable outcomes had either empyemas, in which pleural drainage plays an important if not primary role, or soft-tissue infections. Only one of four patients with an anaerobic lung abscess or aspiration pneumonia had a complete cure, although two patients did have an initial response with subsequent relapse. We believe their data and our recent experience with the failure of erythromycin in two clinical anaerobic pulmonary abscesses do not presently support the use of this agent in the therapy for anaerobic pulmonary infections.
Report of Cases.—Case 1.—
A 43-year-old woman with a history of alcohol abuse was evaluated for malaise, a nonproductive cough,