Boxed Warning Section
Clostridium difficile
associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin hydrochloride and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of
C. difficile
.
Because clindamycin hydrochloride 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.
C. difficile
produces toxins A and B, which contribute to the development of CDAD. Hypertoxin producing strains of
C. difficile
cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against
C. difficile
may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of
C. difficile
, and surgical evaluation should be instituted as clinically indicated.
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CLINDAMYCIN SUMMARY
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 hydrochloride capsules, USP are indicated in the treatment of serious infections caused by susceptible anaerobic bacteria.
Clindamycin hydrochloride capsules, USP are 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 (e.g., 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 tubo-ovarian 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 hydrochloride and other antibacterial drugs, clindamycin hydrochloride 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
Clindamycin versus trimethoprim-sulfamethoxazole for uncomplicated skin
infections. [2015]
community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is unclear... CONCLUSIONS: We found no significant difference between clindamycin and TMP-SMX,
Efficacy of clindamycin in reducing pain following tonsillectomy in adults: a
double-blind, randomised trial. [2013]
reducing throat pain after tonsillectomy in adult patients... CONCLUSION: Topical clindamycin was not demonstrated to be more effective than
Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne
vulgaris. [2013]
Nicotinamide and clindamycin gels are two popular topical medications for acne
vulgaris... Skin type is a significant factor in choosing
between topical nicotinamide and clindamycin in patients with acne vulgaris.
Fitzpatrick skin types and clindamycin phosphate 1.2%/benzoyl peroxide gel:
efficacy and tolerability of treatment in moderate to severe acne. [2012]
efficacy of acne medications in skin of color... CONCLUSIONS: Acne subjects with Fitzpatrick skin types IV-VI were not found to be
Treatment of moderate to severe acne vulgaris in a Hispanic population: a
post-hoc analysis of efficacy and tolerability of clindamycin phosphate
1.2%/benzoyl peroxide 2.5% gel. [2012]
in Hispanics... CONCLUSIONS: Overall efficacy and tolerability with clindamycin phosphate
Reports of Suspected Clindamycin Side Effects
Diarrhoea (42),
Rash (24),
Pyrexia (23),
Completed Suicide (20),
Toxicity TO Various Agents (20),
Pancytopenia (17),
Gastrooesophageal Reflux Disease (16),
Chest Pain (15),
Vomiting (15),
Drug Hypersensitivity (15), more >>
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PATIENT REVIEWS / RATINGS / COMMENTSBased on a total of 8 ratings/reviews, Clindamycin has an overall score of 3.12. The effectiveness score is 6.50 and the side effect score is 4.50. 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 45 year old female patient | | | Rating |
| Overall rating: | | |
| Effectiveness: | | Ineffective |
| Side effects: | | Moderate Side Effects | | |
Treatment Info |
| Condition / reason: | | prophylaxis after oral surgery |
| Dosage & duration: | | 300 mg. taken 3 times per day for the period of 7 days |
| Other conditions: | | none |
| Other drugs taken: | | none | | |
Reported Results |
| Benefits: | | I really don't know if there are any, since I'm taking it prophylactically. |
| Side effects: | | For the first 2 or 3 days I was hungry all the time, I think I've gained weight. I'm on day 5, and now I feel bloated and full, have a little heartburn, food doesn't taste right, and bad taste in mouth. When I belch or pass gas it smells terrible. I wouldn't call it diarrhea, but I'm going more often, and it's just weird. I'll finish the drug, but I don't think I'd take it again. |
| Comments: | | Taking it to prevent infection after dental implant surgery. |
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| | Clindamycin review by 44 year old male patient | | | Rating |
| Overall rating: | | |
| Effectiveness: | | Considerably Effective |
| Side effects: | | Extremely Severe Side Effects | | |
Treatment Info |
| Condition / reason: | | STAPHF INFECTION |
| Dosage & duration: | | 1 pill taken 4 times a day for the period of 14 days |
| Other conditions: | | none |
| Other drugs taken: | | none | | |
Reported Results |
| Benefits: | | infection cleared up in a week |
| Side effects: | | 30 days after finishing the meds i had severe abdominal pains, and was then diagnosed with diverticulitis[hemroids of the colon i was unable to work for 3 and a half months it is now 6 years later and im about to have part of my colon removed due to inflamation of the diverticulitis , the last 6 years have been a living hell from pain to constipation and diareia i hope this works as the drug changed my life from very heathy to very sick and on my death bed twice once from anafalactic shock to the most recent,an abbsessed liver which im still dealing with so i can have my operation and see if i can get rid of the constant pain i,v been in for 6 years. I WOULD NOT WISH THIS ON MY WORST ENEMY |
| Comments: | | 4 times a day for 14 days the pain |
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Page last updated: 2015-08-10
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