Clindamycin chemical structure
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Clindamycin

Clindamycin is a lincosamide antibiotic. Clindamycin is a semisynthetic antibiotic and derived from lincomycin by the addition of chloride. Clindamycin is sold under brand names such as Dalacin and Cleocin. It is most effective against infections involving the following types of organisms: more...

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  • Aerobic gram-positive cocci, including some members of the Staphylococcus and Streptococcus (eg. pneumococcus) genera.
  • Anaerobic gram-negative bacilli, including some members of the Bacteroides and Fusobacterium genera.

It is used primarily to treat infections caused by susceptible anaerobic bacteria. Such infections might include respiratory infections, septicemia and peritonitis. In penicillin allergic patients clindamycin may be used to treat susceptible aerobic infections as well. It is also used to treat bone-infections caused by Staphylococcus aureus. Topical application of clindamycin phosphate can be used to treat severe acne.

Available forms

Clindamycin is commonly administered in penal caps as hydrochloride or in oral suspension as palmitate hydrochloride. It is also available for intravenous injection as phosphate. In topical preparations clindamycin is as hydrochloride or phosphate (Evoclin®).

Mechanism of action

Clindamycin has a bacteriostatic effect. Clindamycin interferes with bacterial protein synthesis, in a similar way as erythromycin and chloramphenicol, by binding to the 50S subunit of the bacterial ribosome. This causes antagonism if administered simultaneously and possible cross-resistance.

Pharmacokinetics

Almost all of orally administered clindamycin is absorbed from the gastro-intestinal tract, and it is widely distributed throughout the body, excluding the central nervous system. Clindamycin phosphate, as injection, is inactive, but it is rapidly hydrolysed in the blood to active clindamycin. High concentrations of clindamycin can be found in the bile (up 100 times higher than in the plasma). Adequate concentrations can also be found in the bone, and there is also active uptake into leucocytes.

Metabolism

Most of clindamycin is metabolised in the liver, and some of its metabolites are active, such as N-demethyl and sulphoxide-metabolites, and some are inactive. Clindamycin's half-life is 21 hours. Both active clindamycin and its metabolites are excreted primarily in the urine and some in the bile.

Side effects

Common side effects are mainly gastrointestinal disturbances. Clindamycin can cause a potentially lethal condition, pseudomembranous colitis, which is caused by Clostridium difficile, a clindamycin resistant bacteria (all the other bacteria have been killed by clindamycin, allowing C. difficile to over-proliferate and cause inflammation of the colon). Rare instances of polyarthritis (inflamation of several joints) have also been reported. In some cases this polyarthritis side effect feels like extreme flu-like aching througout the body.

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Clinical experience results with clindamycin 1% benzoyl peroxide 5% gel (Duac[R]) as monotherapy and in combination. : An article from: Journal of Drugs in Dermatology $5.95 Duac Topical Gel.(New & Approved) : An article from: Skin & Allergy News $5.95
Peritonsillar abscess: a comparison of outpatient IM clindamycin and inpatient IV ampicillin/sulbactam following needle aspiration. : An article from: Ear, Nose and Throat Journal $5.95

Comparison of national, regional, and state susceptibilities of streptococcus pneumoniae isolates to clindamycin and erythromycin: results of the antimicrobial
PURPOSE: The ARM Program, an ongoing project of the University of Florida, documents trends in antimicrobial susceptibility patterns in inpatient/outpatient ...
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Ugwumadu A, Manyonda I, Reid F, Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal ...
Benzoyl peroxide and clindamycin are the two most widely prescribed topical antimicrobials in the treatment of acne - Washington Whispers - Brief Article
BENZOYL PEROXIDE AND CLINDAMYCIN ARE THE TWO most widely prescribed topical antimicrobials in the treatment of acne. This study compared the antimicrobial ...
Reassessment of combining benzoyl peroxide with clindamycin - Letters To The Editor - Letter to the Editor
Dear Dr. Robins: I was most interested in the article by Tschen and Jones concerning the clinical and antimicrobial results of the topical combination ...
Comparison of clindamycin/benzoyl peroxide, tretinoin plus clindamycin, and the combination of clindamycin/benzoyl peroxide and tretinoin plus clindamycin
Abstract In the treatment of mild to moderate acne vulgaris, the combination of an antibiotic and benzoyl peroxide provides enhanced efficacy over ...
Peritonsillar abscess: a comparison of outpatient IM clindamycin and inpatient IV ampicillin/sulbactam following needle aspiration
Abstract In an attempt to assess the effect of antibiotic choice on the treatment of peritonsillar abscess, we compared the clinical efficacy of empiric ...
Once-daily clindamycin foam easier for patients
Compliance among adults and adolescents with acne vulgaris may improve with once-a-day clindamycin foam, which has been approved by the Food and Drug ...

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