Clindamycin

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


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

  • Skin and soft tissue infections
  • Respiratory tract infections
  • Bone and joint infections
  • Pelvic infections
  • Intra-abdominal infections
  • Septicaemia and endocarditis
  • Dental infections
  • Multi-drug resistant Plasmodium falciparum (malaria) infection

Clindamycin can be used topically, orally or intravenously. In New Zealand (July 2017), it is available on prescription as:

  • ClindaTech™ topical solution
  • Clindamycin ABM, Dalacin C™, Topicil™ capsule
  • Dalacin C™ phosphate solution for intravenous or intramuscular injection

In other countries, it may also be available as a topical foam, vaginal cream and oral suspension.

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.

Clindamycin vaginal cream is used to treat bacterial vaginosis.

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 of clindamycin

Oral 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 when prescribed clindamcyin

  • The safety of use in pregnancy has not been established.
  • Clindamycin has been reported to appear in breast milk.
  • If therapy is prolonged, liver and renal function tests may be monitored periodically.
  • May enhance the action of neuromuscular blocking agents.
  • May counteract the effects of erythromycin.
New Zealand approved datasheets are the official source of information for these prescription medicines, including approved uses and risk information. Check the individual New Zealand datasheet on the Medsafe website.

 

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