Clindamycin information from DrugsUpdate
P - Caution when used during pregnancy
L - Caution when used during lactation
FI - Food *
Clindamycin is a lincosamide antibiotic. It is usually used to treat infections with anaerobic bacteria but can also be used to treat some protozoal diseases, such as malaria. It is a common topical treatment for acne and can be useful against some methicillin-resistant Staphylococcus aureus (MRSA) infections.
The most severe common adverse effect of clindamycin is Clostridium difficile-associated diarrhea (the most frequent cause of pseudomembranous colitis).Although this side-effect occurs with almost all antibiotics, including beta-lactam antibiotics, it is classically linked to clindamycin use.
Clindamycin is marketed under various trade names, including CLINCIN, Dalacin, Clindacin, Cleocin, and Evoclin (clindamycin by itself), Duac, BenzaClin, and Clindoxyl and Acanya (in combination with benzoyl peroxide), and Ziana (with tretinoin). Clindamycin is also available as a generic drug.
Pharmacodynamics
Pharmacokinetics
Clindamycin inhibits protein synthesis by reversibly binding to the 50S subunit of the ribosomal thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting to stunted cell growth.
Absorption
90% absorbed from the GI tract (oral), absorbed from the skin (topical), systemically (intravaginal); rate of absorption may be reduced by the presence of food.
Distribution
Body tissues and fluids (wide), bone, bile (high concentrations), leukocytes, macrophages; crosses the placenta and enters breast milk. Protein-binding: >90%
Metabolism
Hepatic; converted to N-demethyl and sulfoxide metabolites and some inactive metabolites.
Excretion
Via urine (10% as active drug or metabolites), via faeces (4% as inactive metabolites); 2-3 hours (elimination half-life), may be prolonged in preterm neonates and severe renal impairment.
Clindamycin Indications / Clindamycin Uses
Information Not Available
Clindamycin Adverse Reactions / Clindamycin Side Effects
Diarrhoea, nausea, vomiting, abdominal pain; erythema multiforme, contact dermatitis, exfoliative and vesiculous dermatitis, urticaria; eosinophilia; local irritation, thrombophloebitis. Potentially Fatal: Gasping syndrome (neonates); pseudomembranous colitis.
Precautions
Information Not Available
Special Precautions
Renal and hepatic diseases; pregnancy and lactation; GI disease; elderly, females, neonates, atopic patients. Regular monitoring of blood counts, liver and kidney functions.
Other Drug Interactions
Antagonises effects of parasympathetics.
Potentially Fatal: Respiratory depression with neuromuscular blockers.
Other Interactions
Food Interactions
May reduce rate of absorption.
Dosage
Oral
Serious anaerobic infections
Adult: 150-300 mg every 6 hours. May increase to 450 mg every 6 hours in more severe infections. Max: 1.8 g/day.
Child: 3-6 mg/kg every 6 hours. Children weighing <10 kg should receive at least 37.5 mg every 8 hours.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Oral
Prophylaxis of endocarditis
Adult: 600 mg 1 hour before dental procedure. 300 mg may be given via IV injection (over at least 10 minutes) for high-risk patients undergoing dental procedures involving general anaesthesia.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Intravenous
Serious anaerobic infections
Adult: 0.6-2.7 g daily in divided doses, increased to 4.8 g daily in very severe infections.
Child:>1 month: 15-40 mg/kg daily in divided doses. A min dose of 300 mg daily should be given regardless of body weight.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Intravenous
Toxic shock syndrome
Adult: 900 mg every 8 hours, in combination with penicillin G or ceftriaxone.
Hepatic impairment: Severe:dosage adjustment may be needed.
Intravenous
Pelvic inflammatory disease
Adult: 900 mg every 8 hours. To be used with gentamicin.
Hepatic impairment: Severe: dosage adjustment may be needed.
Vaginal Bacterial vaginosis
Adult: As pessary or 2% cream: 100 mg once nightly for 3-7 days.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Topical/Cutaneous Acne
Adult: As 1% preparation: Apply a thin layer onto affected area bid.
Renal impairment: Severe: dosage adjustment may be needed.
Food(before/after)
Granules
Should be taken with food.
Capsule
May be taken with or without food. (Swallow whole with a full glass of water & in an upright position.)
List of Contraindications
Clindamycin and Pregnancy
Caution when used during pregnancy.
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
Clindamycin and Lactation
Caution when used during lactation
Clindamycin and Children
Information Not Available
Clindamycin and Geriatic
Information Not Available
Clindamycin and Other Contraindications
Hypersensitivity
Storage
Information Not Available
Lab interference
Information Not Available
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