Clindamycin

Author: Dr Weng Chyn Chan MB ChB, Dept of Dermatology Waikato Hospital, 2004.

Clindamycin is a lincosamide antibiotic. It is used to treat infections due to susceptible bacteria.

Clindamycin can be used topically, orally or intravenously. In New Zealand, it is available as:

Clindamycin is quickly absorbed after oral administration and absorption is not affected by food.

When do dermatologists use clindamycin?

Clindamycin is prescribed by dermatologists for a variety of skin conditions.

Indications for clindamycin solution, gel or lotion include:

Clindamycin is also available to treat acne in combination with benzyol peroxide, e.g. Duac® Once Daily gel.

Together with rifampicin, uses for oral clindamycin include:

Clindamycin is active against gram positive organisms (Staphylococcus aureus, Staphylococcus epidermidis, streptococci and proprionibacterium) and gram negative organisms (bacteroides species). Susceptible organisms include both aerobic and anaerobic bacteria.

Side effects

Clindamycin is generally well tolerated. However there are important side effects that may affect some people taking the medicine orally or by injection (they are very rarely seen with the topical preparations).

Gastrointestinal
Clindamycin has been associated with colitis (inflammation of the bowel); this is caused by a toxin produced from an overgrowth of a bacterium, Clostridium difficile. Symptoms can range from mild watery diarrhoea to severe, persistent diarrhoea with fever, abdominal cramps and the passage of blood and mucus. It may be potentially serious. If significant diarrhoea develops whilst taking clindamycin, the drug should be stopped. A stool test may show the presence of the toxin. Treatment depends on the severity of symptoms. Stopping the drug may be enough; however, more severe cases may require hospitalisation for intravenous fluid and antibiotic treatment.
Allergic rashes
Hives, rarely erythema multiforme and anaphylactoid reactions have been reported.
Liver
Jaundice (dark urine, yellow eyes and skin).
Musculoskeletal
Rarely polyarthritis (inflammation of several joints) has been reported.

Precautions

Related information

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