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Clindamycin is an antibiotic useful for the treatment of a number of bacterial infections.
Common side effects include nausea, diarrhea, rash, and pain at the site of injection.
Clindamycin was first made in 1966 or 1967.
Contents
1 Medical uses
1.1 Acne
1.2 Susceptible bacteria
1.3 D-Test
1.4 Malaria
1.5 Other
2 Side effects
2.1 Breastfeeding
3 Interactions
4 Chemistry
5 Mechanism of action
6 Market
6.1 Cost
6.2 Available forms
7 Veterinary use
8 References
9 External links
Medical uses
Clindamycin is used primarily to treat anaerobic infections caused by susceptible anaerobic bacteria, including dental infections,
Acne
The use of clindamycin in conjunction with benzoyl peroxide is more effective in the treatment of acne than the use of either product by itself.
Clindamycin and adapalene in combination are also more effective than either drug alone, although adverse effects are more frequent.
Susceptible bacteria
It is most effective against infections involving the following types of organisms:
Aerobic Gram-positive cocci, including some members of the Staphylococcus and Streptococcus ( e.g. pneumococcus ) genera, but not enterococci.
Anaerobic, Gram-negative rod-shaped bacteria, including some Bacteroides, Fusobacterium, and Prevotella, although resistance is increasing in Bacteroides fragilis.
Most aerobic Gram-negative bacteria (such as Pseudomonas, Legionella, Haemophilus influenzae and Moraxella ) are resistant to clindamycin,
The following represents MIC susceptibility data for a few medically significant pathogens.
Staphylococcus aureus : 0.016 μg/ml – >256 μg/ml
Streptococcus pneumoniae : 0.002 μg/ml – >256 μg/ml
Streptococcus pyogenes : 64 μg/ml
D-Test
D test
When testing a gram-positive culture for sensitivity to clindamycin, it is common to perform a “D-Test” to determine if there is a macrolide -resistant subpopulation of bacteria present. This test is necessary because some bacteria express a phenotype known as MLS B, in which susceptibility tests will indicate the bacteria are susceptible to clindamycin, but in vitro the pathogen displays inducible resistance.
To perform a D-test, an agar plate is inoculated with the bacteria in question and two drug-impregnated disks (one with erythromycin, one with clindamycin) are placed 15–20 mm apart on the plate. If the area of inhibition around the clindamycin disk is “D” shaped, the test result is positive and clindamycin should not be used due to the possibility of resistant pathogens and therapy failure. If the area of inhibition around the clindamycin disk is circular, the test result is negative and clindamycin can be used.
Malaria
Given with chloroquine or quinine, clindamycin is effective and well tolerated in treating Plasmodium falciparum malaria; the latter combination is particularly useful for children, and is the treatment of choice for pregnant women who become infected in areas where resistance to chloroquine is common.
Other
Clindamycin may be useful in skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus (MRSA); many strains of MRSA are still susceptible to clindamycin; however, in the United States spreading from the West Coast eastwards, MRSA is becoming increasingly resistant.
Clindamycin is used in cases of suspected toxic shock syndrome,
Clindamycin has been proven to decrease the risk of premature births in women diagnosed with bacterial vaginosis during early pregnancy to about a third of the risk of untreated women.
The combination of clindamycin and quinine is the standard treatment for severe babesiosis.
Clindamycin may also be used to treat toxoplasmosis,
Side effects
Common adverse drug reactions associated with systemic clindamycin therapy – found in over 1% of people – include: diarrhea, pseudomembranous colitis, nausea, vomiting, abdominal pain or cramps and/or rash. High doses (both intravenous and oral) may cause a metallic taste. Common adverse drug reactions associated with topical formulations – found in over 10% of people – include: dryness, burning, itching, scaliness, or peeling of skin (lotion, solution); erythema (foam, lotion, solution); oiliness (gel, lotion). Additional side effects include contact dermatitis. Common side effects – found in over 10% of people – in vaginal applications include fungal infection.
Pseudomembranous colitis is a potentially lethal condition commonly associated with clindamycin, but which occurs with other antibiotics, as well.
Rarely – in less than 0.1% of patients – clindamycin therapy has been associated with anaphylaxis, blood dyscrasias, polyarthritis, jaundice, raised liver enzyme levels, renal dysfunction, cardiac arrest, and/or hepatotoxicity.
Breastfeeding
Clindamycin is classified as compatible with breastfeeding by the American Academy of Pediatrics,
Interactions
Clindamycin may prolong the effects of neuromuscular-blocking drugs, such as succinylcholine and vecuronium. and possible cross-resistance.
Chemistry
Clindamycin phosphate
Clindamycin is a semisynthetic derivative of lincomycin, a natural antibiotic produced by the actinobacterium Streptomyces lincolnensis. It is obtained by 7( S )- chloro – substitution of the 7( R )- hydroxyl group of lincomycin.
The topically used clindamycin phosphate is a phosphate- ester prodrug of clindamycin.
Mechanism of action
Clindamycin has a primarily bacteriostatic effect. It is a bacterial protein synthesis inhibitor by inhibiting ribosomal translocation,
The X-ray crystal structures of clindamycin bound to ribosomes (or ribosomal subunits) derived from Escherichia coli,
Market
Cost
It is available as a generic medication and is not very expensive.
Available forms
Clindamycin preparations for oral administration include capsules (containing clindamycin hydrochloride ) and oral suspensions (containing clindamycin palmitate hydrochloride).
Several combination acne treatments containing clindamycin are also marketed, such as single-product formulations of clindamycin with benzoyl peroxide —sold as BenzaClin ( Sanofi-Aventis ), Duac (a gel form made by Stiefel ), and Acanya, among other trade names—and, in the United States, a combination of clindamycin and tretinoin, sold as Ziana. In India, vaginal suppositories containing clindamycin in combination with clotrimazole are manufactured by Olive Health Care and sold as Clinsup-V. In Egypt, vaginal cream containing clindamycin produced by Biopharmgroup sold as Vagiclind indicated for vaginosis.
Clindamycin is available as a generic drug, for both systemic (oral and intravenous) and topical use.
Clindamycin is marketed as generic and under trade names including Cleocin HCl, Clindacin, Dalacin, Evoclin and Lincocin (Bangladesh). Other combination products include Clindoxyl.
Veterinary use
The veterinary uses of clindamycin are quite similar to its human indications, and include treatment of osteomyelitis, Toxoplasmosis rarely causes symptoms in cats, but can do so in very young or immunocompromised kittens and cats.

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