From the FDA Drug Label
Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.
The FDA drug label does mention the use of clindamycin for treating serious infections caused by staphylococci, but it does not specifically mention toxic shock syndrome.
- The label lists serious respiratory tract infections and serious skin and soft tissue infections as indications for clindamycin use in staphylococcal infections.
- However, toxic shock syndrome is not explicitly mentioned as an indication. 1
From the Research
Yes, clindamycin is regularly used for treating staphylococcal toxic shock syndrome (TSS). The typical regimen for treating staphylococcal TSS includes:
- Clindamycin: 600-900 mg IV every 8 hours
- Combined with an anti-staphylococcal beta-lactam antibiotic (e.g., nafcillin or oxacillin) or vancomycin (in methicillin-resistant S. aureus prevalent areas) Clindamycin is particularly effective in TSS for several reasons:
- It inhibits toxin production by Staphylococcus aureus, which is crucial in managing TSS 2
- It has excellent tissue penetration
- It retains activity even when bacteria are in a stationary growth phase Treatment duration is typically 7-14 days, depending on clinical response 3. Supportive care, including fluid resuscitation and management of organ dysfunction, is also essential in TSS treatment. It's essential to note that while clindamycin is effective, it should not be used as monotherapy due to the risk of inducing resistance. The combination with a beta-lactam antibiotic provides synergistic effects and broader coverage against potential methicillin-resistant strains. According to the most recent study 3, antibiotics for treatment of this condition should include a penicillinase-resistant penicillin, cephalosporin, or vancomycin (in methicillin-resistant S. aureus prevalent areas) in combination with either clindamycin or linezolid. Focused history, physical examination, and laboratory investigations are crucial for the diagnosis and management of this condition. In the context of real-life clinical medicine, it is crucial to prioritize the use of clindamycin in combination with other antibiotics for the treatment of staphylococcal TSS, given its effectiveness in inhibiting toxin production and its excellent tissue penetration 2, 3.