Clindamycin
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Clindamycin
Cleocin (oral, IV); Clindesse, Cleocin (vaginal); Clindets, Cleocin T (topical)
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Summary
Classes
Common uses
Skin and soft tissue infections (including some MRSA strains)0, Anaerobic odontogenic infections0, Bacterial vaginosis (vaginal)0, Acne vulgaris (topical, often with benzoyl peroxide)0, Adjunct to β-lactam in toxin-mediated streptococcal/staphylococcal infections (toxic shock, necrotizing fasciitis) for ribosomal suppression of toxin production0, Dental prophylaxis in penicillin allergy0
Pharmacy
Starting dose
Oral 300-450 mg PO QID; IV 600-900 mg q8h; topical 1% solution/gel BID; vaginal 100 mg ovule × 3 days or 2% cream × 7 days
Preparations
75, 150, 300 mg capsules; 75 mg/5 mL solution; 150 mg/mL IV; 1% topical; 2% vaginal cream
US FDA Max
4.8 g/d (IV severe infection)
Pharmacology
Routes
Oral, IV, IM, topical, vaginal
Onset
Hours
Duration
6-8 hours
Half-life
~2.5-3 hours[1]
Bioavailability
~90% (oral)[1]
Pregnancy
Generally considered safe.[citation needed]
Legal status
Purported mechanism
Clindamycin reversibly binds the 23S rRNA of the bacterial 50S ribosomal subunit at a site overlapping the macrolide binding site, blocking peptide bond formation and inhibiting protein synthesis; the result is bacteriostatic against most organisms and bactericidal at high concentrations against susceptible strains.0 Active against gram-positives (Staph including some MRSA, streptococci including viridans), anaerobes (Bacteroides, Clostridia other than difficile, Peptostreptococcus), and Toxoplasma. Inducible MLSb resistance (D-test required for staph) and rising community MRSA resistance limit empiric reliability. Strong association with C. difficile colitis is the clinical-use ceiling[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Cleocin HCl (clindamycin HCl), Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/050162s100lbl.pdf