Description

Simple

An antibiotic used to treat acne and certain types of serious infections.

Clinical

A lincosamide antibiotic used to treat serious infections caused by susceptible anaerobic, streptococcal, staphylococcal, and pneumococcal bacteria.

Overview

Clindamycin is a semi-synthetic lincosamide antibiotic used in the treatment of a variety of serious infections due to susceptible microorganisms[14,13] as well as topically for acne vulgaris.[12] It has a relatively narrow spectrum of activity that includes anaerobic bacteria as well as gram-positive cocci and bacilli and gram-negative bacilli.[8] Interestingly, clindamycin appears to carry some activity against protozoans, and has been used off-label in the treatment of toxoplasmosis, malaria, and babesiosis.[9]

Clindamycin is derived from, and has largely replaced, [lin... Read more

Pharmacology

Indication

In oral and parenteral formulations, clindamycin is indicated for the treatment of serious infections caused by susceptible anaerobic bacteria, as well as susceptible staphylococci, streptococci, and pneumococci.[ Read more

Pharmacodynamic

Clindamycin exerts its bacteriostatic effect via inhibition of microbial protein synthesis.[ Read more

Mechanism of action

Clindamycin inhibits bacterial protein synthesis by binding to 23S RNA of the 50S subunit of the bacterial ribosome.[14] It impedes both the assembly of the ri... Read more

Absorption

Oral bioavailability is nearly complete, at approximately 90%, and peak serum concentrations (Cmax) of, on average, 2.50 µg/mL are reached at 0.75 hours (Tmax).[ Read more

Protein binding

Clindamycin protein binding is concentration-dependent and ranges from 60-94%. It is bound primarily to alpha-1-acid glycoprotein in the serum.[20]

Volume of distribution

Clindamycin is widely distributed in the body, including into bone, but does not distribute into cerebrospinal fluid. The volume of distribution has been variably estimated between 43-74 L.[ Read more

Clearance

The plasma clearance of clindamycin is estimated to be 12.3-17.4 L/h, and is reduced in patients with cirrhosis and altered in those with anemia.[ Read more

Half life

The elimination half-life of clindamycin is about 3 hours in adults and 2.5 hours in children.[15, Read more

Route of elimination

Approximately 10% of clindamycin bioactivity is excreted in the urine and 3.6% in the feces, with the remainder excreted as inactive metabolites.[15]

Toxicity

The oral LD50 in mice and rats is 2540 mg/kg and 2190 mg/kg, respectively.[19]

While no cases of overdose have been reported, symptoms are expected to be consistent with the adverse effect profil... Read more

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: History of antibiotic-associated colitis
      • Drugbank Id: DBCOND0125742
  • Regions: US
  • Patient Conditions:
      • Name: Ulcerative Colitis
      • Drugbank Id: DBCOND0029012
  • Regions: US
  • Patient Conditions:
      • Name: Regional Enteritis
      • Drugbank Id: DBCOND0053624
  • Hypersensitivity:
    • true
    • lincomycin
  • Regions: US

Food Interactions

  • Take with a full glass of water. Clindamycin may cause esophageal irritation if the dosage form becomes lodged.
  • Take with or without food. Food does not appreciably alter the absorption of clindamycin.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The risk or severity of bleeding can be increased when Clindamycin is combined with (R)-warfarin.
(S)-Warfarin
The risk or severity of bleeding can be increased when Clindamycin is combined with (S)-Warfarin.
4-hydroxycoumarin
The risk or severity of bleeding can be increased when Clindamycin is combined with 4-hydroxycoumarin.
Abatacept
The metabolism of Clindamycin can be increased when combined with Abatacept.
Acalabrutinib
The metabolism of Clindamycin can be decreased when combined with Acalabrutinib.
Acenocoumarol
The risk or severity of bleeding can be increased when Clindamycin is combined with Acenocoumarol.
Acepromazine
Clindamycin may increase the neurotoxic activities of Acepromazine.
Aceprometazine
Clindamycin may increase the neurotoxic activities of Aceprometazine.
Acetaminophen
The metabolism of Clindamycin can be increased when combined with Acetaminophen.
Acetophenazine
Acetophenazine may increase the neurotoxic activities of Clindamycin.
Adalimumab
The metabolism of Clindamycin can be increased when combined with Adalimumab.
Afelimomab
The metabolism of Clindamycin can be increased when combined with Afelimomab.
Alcuronium
The risk or severity of neuromuscular blockade can be increased when Clindamycin is combined with Alcuronium.
Alfentanil
The metabolism of Clindamycin can be decreased when combined with Alfentanil.
Alimemazine
The metabolism of Alimemazine can be increased when combined with Clindamycin.
Alpelisib
The metabolism of Clindamycin can be increased when combined with Alpelisib.
Alprazolam
The metabolism of Clindamycin can be decreased when combined with Alprazolam.
Ambrisentan
The metabolism of Ambrisentan can be decreased when combined with Clindamycin.
Amineptine
Clindamycin may increase the neurotoxic activities of Amineptine.
Aminoglutethimide
The metabolism of Clindamycin can be increased when combined with Aminoglutethimide.
20 References
  1. 1 . Daum RS: Clinical practice. Skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. N Engl J Med. 2007 Jul 26;357(4):380-90.PubMed: 17652653
  2. 2 . Klempner MS, Styrt B: Clindamycin uptake by human neutrophils. J Infect Dis. 1981 Nov;144(5):472-9.PubMed: 6171600
  3. 3 . Lamont RF: Can antibiotics prevent preterm birth--the pro and con debate. BJOG. 2005 Mar;112 Suppl 1:67-73.PubMed: 15715599
  4. 4 . Plaisance KI, Drusano GL, Forrest A, Townsend RJ, Standiford HC: Pharmacokinetic evaluation of two dosage regimens of clindamycin phosphate. Antimicrob Agents Chemother. 1989 May;33(5):618-20.PubMed: 2751277
  5. 5 . Wynalda MA, Hutzler JM, Koets MD, Podoll T, Wienkers LC: In vitro metabolism of clindamycin in human liver and intestinal microsomes. Drug Metab Dispos. 2003 Jul;31(7):878-87. doi: 10.1124/dmd.31.7.878.PubMed: 12814964
  6. 6 . Leigh DA: Antibacterial activity and pharmacokinetics of clindamycin. J Antimicrob Chemother. 1981 Jun;7 Suppl A:3-9. doi: 10.1093/jac/7.suppl_a.3.PubMed: 7019193
  7. 7 . Bouazza N, Pestre V, Jullien V, Curis E, Urien S, Salmon D, Treluyer JM: Population pharmacokinetics of clindamycin orally and intravenously administered in patients with osteomyelitis. Br J Clin Pharmacol. 2012 Dec;74(6):971-7. doi: 10.1111/j.1365-2125.2012.04292.x.PubMed: 22486719
  8. 8 . Spizek J, Rezanka T: Lincosamides: Chemical structure, biosynthesis, mechanism of action, resistance, and applications. Biochem Pharmacol. 2017 Jun 1;133:20-28. doi: 10.1016/j.bcp.2016.12.001. Epub 2016 Dec 7.PubMed: 27940264
  9. 9 . Spizek J, Rezanka T: Lincomycin, clindamycin and their applications. Appl Microbiol Biotechnol. 2004 May;64(4):455-64. doi: 10.1007/s00253-003-1545-7. Epub 2004 Feb 5.PubMed: 14762701
  10. 10 . FDA Approved Drug Products: Onexton (clindamycin phosphate/benzoyl peroxide) topical gel Link
  11. 11 . FDA Approved Drug Products: Ziana (clindamycin phosphate/tretinoin) topical gel Link
  12. 12 . FDA Approved Drug Products: Evoclin (clindamycin phosphate) topical foam Link
  13. 13 . FDA Approved Drug Products: Clindesse (clindamycin phosphate) vaginal cream Link
  14. 14 . FDA Approved Drug Products: Clindamycin in 0.9% NaCl for intravenous injection Link
  15. 15 . FDA Approved Drug Products: Cleocin (clindamycin hydrochloride) oral capsules Link
  16. 16 . FDA Approved Drug Products: Cleocin T (clindamycin phosphate) topical gel/solution/lotion Link
  17. 17 . FDA Approved Drug Products: Cleocin (clindamycin phosphate) vaginal suppositories Link
  18. 18 . Health Canada Product Monograph: Clindets (clindamycin phosphate) topical swabs Link
  19. 19 . CaymanChem: Clindamycin MSDS Link
  20. 20 . Health Canada Product Monograph: Clindamycin oral capsules Link