WARNING
Pseudomembranous colitis has been reported with nearly all antibacterial agents, including clindamycin, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.
Because clindamycin therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate, as described in the INDICATIONS AND USAGE section. It should not be used in patients with nonbacterial infections such as most upper respiratory tract infections. Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is one primary cause of "antibiotic-associated colitis".
After the diagnosis of pseudomembranous colitis has been established, therapeutic measures should be initiated. Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with an antibacterial drug clinically effective against C. difficile colitis.
Diarrhea, colitis, and pseudomembranous colitis have been observed to begin up to several weeks following cessation of therapy with clindamycin.
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CLINDAMYCIN SUMMARY
Clindamycin Hydrochloride Capsules, USP
Clindamycin hydrochloride is the hydrated hydrochloride salt of clindamycin. Clindamycin is a semisynthetic antibiotic produced by a 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound lincomycin.
Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (eg, erythromycin).
Anaerobes: Serious respiratory tract infections such as empyema, anaerobic pneumonitis and lung abscess; serious skin and soft tissue infections; septicemia; intra-abdominal infections such as peritonitis and intra-abdominal abscess (typically resulting from anaerobic organisms resident in the normal gastrointestinal tract); infections of the female pelvis and genital tract such as endometritis, nongonococcal tuboovarian abscess, pelvic cellulitis and postsurgical vaginal cuff infection.
Streptococci: Serious respiratory tract infections; serious skin and soft tissue infections.
Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.
Pneumococci: Serious respiratory tract infections.
Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Clindamycin HCl and other antibacterial drugs, Clindamycin HCl should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
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NEWS HIGHLIGHTS
Published Studies Related to Clindamycin
Comparing a novel solubilized benzoyl peroxide gel with benzoyl peroxide/clindamycin: final data from a multicenter, investigator-blind, randomized study. [2009.09]
INTRODUCTION: A solubilized 5% BPO gel has been developed to enhance the bioavailability, follicular penetration, and efficacy of BPO... CONCLUSION: Compared with BPO/clindamycin, the solubilized BPO gel offers significantly greater reductions in non-inflammatory lesion count and comparable reductions in inflammatory lesion count in the absence of an antibiotic.
Efficacy and tolerability of a fixed combination of clindamycin phosphate (1.2%) and low concentration benzoyl peroxide (2.5%) aqueous gel in moderate or severe acne subpopulations. [2009.08]
BACKGROUND: Oral antibiotics are commonly prescribed for moderate or severe acne, but there may be limitations due to concerns about side effects associated with systemic treatments. OBJECTIVE: To evaluate the efficacy and safety of a fixed combination clindamycin phosphate 1.2% and benzoyl peroxide 2.5% (clindamycin-BP 2.5%) aqueous gel in the treatment of moderate or severe acne subpopulations... CONCLUSION: Clindamycin-BP 2.5% aqueous gel is an effective and safe once-daily treatment for moderate or severe acne.
A 3-step acne system containing solubilized benzoyl peroxide versus clindamycin-benzoyl peroxide. [2009.07]
A 3-step acne system has been developed to enhance the bioavailability and follicular penetration of benzoyl peroxide (BPO). Participants with mild to moderate facial acne vulgaris were randomly assigned to 10 weeks' facial treatment with the 3-step acne system (proprietary salicylic acid cleanser 2% twice daily, proprietary salicylic acid toner 2% once daily, and solubilized BPO gel 5% twice daily) or with control cleanser twice daily plus clindamycin 1%-BPO 5% gel (jar formulation) twice daily...
Comparison of 2 clindamycin 1%-benzoyl peroxide 5% topical gels used once daily in the management of acne vulgaris. [2009.05]
Combination therapy for the topical treatment of acne vulgaris using benzoyl peroxide (BPO) and an antibiotic is more efficacious and better tolerated than treatment with either component alone... The addition of hydrating excipients in the C/BPO HE formulation appears to improve patient tolerance and acceptance, which will likely help patients to comply with therapy.
Tolerability of clindamycin/tretinoin gel vs. tretinoin microsphere gel and adapalene gel. [2009.04]
CONCLUSION: CLIN/RA was significantly better tolerated than was 0.1% tretinoin gel, as evidenced by significantly reduced erythema (P < 0.04), scaling (P < 0.03), itching (P < 0.02), burning (P < 0.03) and stinging (P < 0.04). A trend for greater erythema, scaling, and subjective discomfort for 0.1% adapalene gel compared to CLIN/RA was also evident.
Clinical Trials Related to Clindamycin
A Pilot Study of Oral Clindamycin and Pyrimethamine for the Treatment of Toxoplasmic Encephalitis in Patients With AIDS [Completed]
To collect information on the effectiveness and toxicity of clindamycin plus pyrimethamine
and leucovorin calcium for the treatment of acute toxoplasmic encephalitis in adult patients
with AIDS. Toxoplasmic encephalitis (encephalitis caused by Toxoplasma gondii) is the most
frequent cause of focal central nervous system infection in patients with AIDS. If untreated,
the encephalitis is fatal. At present, it is standard practice to give a combination of
pyrimethamine and sulfadiazine to treat toxoplasmic encephalitis. The high frequency of
sulfonamide-induced toxicity in AIDS patients often makes completion of a full course of
therapy difficult. There is some information that high doses of parenteral (such as by
injection) clindamycin used with pyrimethamine may be as effective as pyrimethamine plus
sulfadiazine in the management of the acute phase of toxoplasmic encephalitis in patients
with AIDS. Administration of parenteral clindamycin for prolonged periods of time, however,
is costly, requires hospitalization, and is inconvenient for the patient. There is some
indication that treatment of AIDS patients with acute toxoplasmic encephalitis with oral
clindamycin may be effective. Leucovorin calcium is useful in preventing
pyrimethamine-associated bone marrow toxicity.
Dalacin-T Gel Post Approval Study [Completed]
The Safety and Efficacy of Clindamycin and Primaquine in the Treatment of Mild - Moderate Pneumocystis Carinii Pneumonia in Patients With AIDS [Completed]
Treatment of Malaria in Gabon With Fosmidomycin-Clindamycin [Completed]
Some antibiotics are also effective against malaria parasites. Fosmidomycin is an antibiotic
that has been shown to be effective against malaria, although it cannot achieve a total cure
in all patients. A previous small study has shown that in combination with clindamycin, an
commonly used antibiotic, it is highly effective and safe, in asymptomatic carriers of
malaria parasites. The current study will evaluate the efficacy and safety of the combination
given for three days in children with uncomplicated malaria in Gabon.
Efficacy of Fosmidomycin-Clindamycin for Treating Malaria in Gabonese Children [Active, not recruiting]
There is a necessity for the development of new malaria drugs. Some antibiotics are also
effective against malaria parasites. Fosmidomycin is an antibiotic that has been shown to be
effective against malaria, although it cannot achieve a total cure in all patients. Previous
small studies have shown that in combination with clindamycin, an commonly used antibiotic,
it is highly effective and safe when given for three days, leading to a total cure in most
patients. The current study will evaluate its efficacy in a larger population in Gabon, and
compare its effect with the generally used drug, sulfadoxine-pyrimethamine.
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 5 ratings/reviews, Clindamycin has an overall score of 3.60. The effectiveness score is 6.80 and the side effect score is 4.80. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
| | Clindamycin review by 21 year old female patient | | | Rating |
| Overall rating: | |   |
| Effectiveness: | | Considerably Effective |
| Side effects: | | Moderate Side Effects | | |
Treatment Info |
| Condition / reason: | | Staph Infection |
| Dosage & duration: | | 150mg taken four times a day for the period of 7 days |
| Other conditions: | | Asthma, allergies, eczema, GERD |
| Other drugs taken: | | Reactine, Pantaloc, Advair | | |
Reported Results |
| Benefits: | | My staph infection on my neck and legs started to clear up pretty quickly... within the 2nd day i noticed a huge difference. |
| Side effects: | | i was scared to death to take this medication after i read what other people wrote about this drug... however.. for me it was not that bad... the first 2 doses I had some headaches/dizziness... I think I was just getting used to the drug... it is pretty strong... no stomach issues until day 5 out of 7... a bit of abdominal pain..but nothing major... id rather get rid of the itchy staph infection and suffer with the minor side effects. |
| Comments: | | Taking the drug and putting on topical mupurocin. |
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| | Clindamycin review by 29 year old male patient | | | Rating |
| Overall rating: | | |
| Effectiveness: | | Considerably Effective |
| Side effects: | | Severe Side Effects | | |
Treatment Info |
| Condition / reason: | | Throat Infection |
| Dosage & duration: | | 300MG taken 4 times a day for the period of 4 days |
| Other conditions: | | nothing |
| Other drugs taken: | | Benzydamine (Mouthwash) | | |
Reported Results |
| Benefits: | | Throat infection cleared up by the 2nd day of treatment. |
| Side effects: | | Esophageal irritation making it really painful to have anything like tea or eating anything hot because it feels like it's scraping your esophagus before it reaches your stomach. |
| Comments: | | One 300MG pill of Clindamycin, along with two Advils followed by gargling the Benzydamine, four times a day. To be taken with food. |
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| | Clindamycin review by 61 year old female patient | | | Rating |
| Overall rating: | | |
| Effectiveness: | | Moderately Effective |
| Side effects: | | Severe Side Effects | | |
Treatment Info |
| Condition / reason: | | Post dental work |
| Dosage & duration: | | 25 mg taken 1/day for the period of 10 days |
| Other conditions: | | Arthritis |
| Other drugs taken: | | None | | |
Reported Results |
| Benefits: | | Initial signs of infection appeared to be treated effectively. |
| Side effects: | | After a few days on this medication, it caused persistent diarrhea lasting several weeks. |
| Comments: | | Medication prescribed after root canal dental work to treat initial symptoms of infection. While infection did not occur, diarrhea was so persistent that I had to seek medical treatment. Will not take this again. |
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Page last updated: 2009-10-20
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