Indications
Therapeutic Class
Pharmacology
Clindamycin inhibits protein synthesis by reversibly binding to the 50S ribosomal subunit, thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting to stunted cell growth.
It has activity against-
- Aerobic gram-positive cocci, including: Staphylococcus aureus, Staphylococcus epidermidis (penicillinase and non-penicillinase producing strains), Streptococci, Pneumococci.
- Anaerobic gram-negative bacilli including: Bacteroides species, Fusobacterium species.
- Anaerobic gram-positive non-spore forming bacilli including:
- Propionibacterium species, Eubacterium species, Actinomyces species.
- Anaerobic and microaerophilic gram-positive cocci including: Peptococcus species, Peptostreptococcus species, Microaerophilic streptococci, C. perferinges.
Dosage
Severe anaerobic infections:
- Adult: 150-300 mg 6 hourly, up to 450 mg in severe infections. Max: 1.8 g/day.
- Child: 3-6 mg/kg 6 hourly.
Parenteral-
Severe anaerobic infections:
- Adult: 0.6-2.7 g daily in 2-4 divided doses, increased to 4.8 g daily in life-threatening infections. Infuse IV admin over 10-60 min and at a rate of ≤30 mg/min. Single dose of IM inj should not exceed 600 mg nor is admin of above 1.2 g in a single 1 hour infusion.
- Child: >1 month 15-25 mg/kg daily in 3 or 4 divided doses; in severe infections, increase to 40 mg/kg daily and a min dose of 300 mg daily should be given regardless of body wt.
Topical/Cutaneous-
Acne:
- Adult: As 1% preparation: Apply a thin layer onto affected area bid.
Vaginal-
Bacterial vaginosis:
- Adult: As pessary or 2% cream: 100 mg at bedtime for 3-7 days.
Administration
Clindamycin Lotion 1%: Clean the face or affected area gently with warm water or soap as recommended by the physician. After the skin is dried, apply a thin film of lotion to the affected areas twice daily, in the morning and in the evening.
Do not wash within three hours after using lotion. The treatment period is usually 6 weeks or as advised by the physician.
However, 8 to 12 weeks of treatment may be required for maximum benefit.
Clindamycin 2% Vaginal preparation: One applicator full (approximately 5 gm) intravaginally at bedtime for 7 consecutive days. In patients in whom a shorter treatment course is desirable, a 3 day regimen has been shown to be effective.
Interaction
Contraindications
Side Effects
Pregnancy & Lactation
Pregnancy Category B: Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed.
Lactation: Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.
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