Tissue antibiotic penetration in streptococcal gangrene

The high mortality of streptococcal gangrene was not dramatically reduced by penicillin therapy. Tissue antibiotic penetration was measured in a patient who ultimately succumbed to complications of this disease. High antibiotic levels were found in muscle that subsequently became gangrenous. This suggests that retained streptococcal products produce a continuing inflammatory process with ultimate necrosis of involved structures. Aggressive debridement remains the mainstay of therapy.