Table of Contents
What is Clindamycin?
Clindamycin is an active ingredient used for the treatment of serious infections: pneumonia, osteomyelitis, dental infections, skin infections, acute sinusitis, lung abscess…). The product ingredients of Clindamycin are: Clindamycin hydrochloride (hcl), Clindamycin palmitate hydrochloride and Clindamycin phosphate.
The brand names of Clindamycin in the United States are: Cleocin, Cleocin Phosphate, Cleocin Pediatric, and Cleocin HCl.
Mechanism of action (MOA) of Clindamycin
Inhibits bacterial protein synthesis at 50S ribosomal subunit level and avoids peptide junction formation.
Therapeutic indications, uses and benefits of Clindamycin
Treatment of the following serious infections caused by sensitive microorganisms:
In adults:
- Community-acquired pneumonia caused by Staphylococcus aureus.
- Aspiration pneumonia.
- Empyema (community acquired).
- Lung abscess.
- Acute pharyngo-tonsillitis caused by Group A Streptococcus (S. pyogenes).
- Dental infections.
- Skin and soft tissue infections (complicated and uncomplicated).
- Osteomyelitis.
- Pneumocystis jiroveci (Pneumocystis carinii) pneumonia in HIV-infected patients.
- Toxoplasmic encephalitis in HIV-infected patients.
In children > 1 month and < 18 years: acute sinusitis.
Posology of Clindamycin
1). Oral
Adults: 600-1,800 mg/day in 2, 3 or 4 equal doses depending on the severity, place of infection and sensitivity of the microorganism. Duration: 7 to 14 days.
– Acute ß-haemolytic streptococcal and pharyngo-tonsillitis infections caused by S. pyogenes: 300 mg 2 times/day, 10 days.
– Pelvic inflammatory disease in hospitalized patients: initial, 900 mg/8 h IV, 4 days; 48 h improvement of the patient: 450-600 mg/6 h oral. Total duration: 10-14 days.
– Pneumonia caused by Pneumocystis jiroveci (Pneumocystis carinii) in patients with HIV: 300-450 mg/6 h oral + 15-30 mg/day of primaquine, 21 days.
– Toxoplasmic encephalitis with AIDS: initial, 600-1,200 mg/6 h orally or IV, 2 weeks; followed by 300-600 mg/6 h orally, 8-10 weeks + 25-75 mg/day of pyrimethamine, 8-10 weeks + 10-20 mg/day of folinic acid.
Children > 1 month: 8-25 mg/kg/day in 3-4 equal doses.
2). Intramuscular (IM)/Intravenous (IV)
Adults and adolescents > 12 years:
– Moderately severe infection: 1.8-2.7 g/day, divided into 3-4 equal doses.
– Severe infection: 2.4-2.7 g/day, divided into 2-4 equal doses.
– Very serious infection, with vital risk: up to 4.8 g/day were administered intravenously. Recommended maximum: 2.7 g/day.
Infants and children (> 1 month and ≤ 12 years).
– Serious infections: 15-25 mg/kg/day in 3-4 equal doses.
– More serious infections: 25-40 mg/kg/day in 3-4 equal doses (administer a minimum of 300 mg/day).
Method of administration of Clindamycin
Oral use.
Can be taken with meals. The medicine should be given with a full glass of water to avoid possible esophageal irritation.
Via IM or IV.
It should be diluted before IV administration and perfused for at least 10-40 min.
The concentration should not exceed 12 mg of clindamycin per ml of solution.
Contraindications of Clindamycin
Hypersensitivity to clindamycin or lincomycin.
Also orally: history of colitis associated with antibiotics.
Warnings and precautions with Clindamycin
- Liver failure.
- Kidney failure.
- Risk of: severe hypersensitivity reactions such as drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (NET), and acute generalized exantémica pustulosis (AGEP) (discontinue treatment if present).
- Risk of overgrowth of Clostridium difficile (may cause diarrhea or colitis associated with antibiotics (discontinue treatment if present) and of non-sensitive microorganisms, including fungi.
- Contraindicated medications that inhibit peristalsis. Caution in: inflammatory bowel disease (e.g. Crohn’s disease or ulcerative colitis) and concomitant treatment with neuromuscular blockers.
- Monitor renal, hepatic and blood counts.
- Do not use in the treatment of meningitis.
- IV: avoid rapid injection (can cause serious effects on the heart).
Liver failure
Caution.
Kidney failure
Caution.
Interactions with Clindamycin
- Risk of neuromuscular blockade with: other neuromuscular blocking agents (e.g. tubocurarine, pancuronium or suxamethonium), monitor.
- Avoid with: oral typhus vaccine (do not administer within 3 days after and after vaccination).
- Diminished clearance with: CYP3A4 and CYP3A5 inhibitors.
- Increased clearance with: CYP3A4 and CYP3A5 inducers (e.g. rifampicin).
- Antagonism with: erythromycin.
- Can decrease bactericidal effect of: aminoglycosides.
- Increased coagulation tests (INR) and/or bleeding with: vitamin K antagonists (acenocumarol, warfarin, fluindione).
Pregnancy and Clindamycin
Assess risk/benefit.
Animal studies have shown reproductive toxicity. It crosses the placental barrier in humans.
Breastfeeding
Clindamycin is excreted in breast milk after oral or intravenous administration, and concentrations of 0.7 – 3.8 micrograms/ml may be reached.
Due to potential serious adverse reactions in the infant, the use of clindamycin during lactation is contraindicated.
Effects on driving ability
Dalacin’s influence on the ability to drive or use machines is nil or negligible.
Adverse reactions and side effects of Clindamycin
Pseudomembranous colitis.
Diarrhea,
Abdominal pain
Alterations in PFH.
Intramuscular (IM): local irritation, pain, indurations, sterile abscesses.
Intravenous (IV): pain, thrombophlebitis.
⭐⭐⭐⭐⭐ VIDEO OF CLINDAMYCIN/CLEOCIN (DRUG)
Source: The content of this active ingredient has been written taking into account the clinical and molecular information of all medicines authorised and marketed in the United States under the Unique Ingredient Identifier (UNII) by the Substance Registration System (SRS) of the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP).
In order to know in detail the information authorized by the FDA for each drug, you should consult the corresponding medication guide authorized by the FDA.
Resources:
UNII: 3U02EL437C
ChemIDplus
DrugPortal
PubChem CID: 446598
NCI Thesaurus: C377