From the Guidelines
Clindoxygel (clindamycin) should be applied as a thin film once daily to the skin where acne lesions appear, covering the entire affected area lightly. This treatment protocol is based on the guidelines of care for the management of acne vulgaris, which recommends applying a thin film of clindamycin once daily to the affected skin areas 1. The dosing instructions are clear: apply enough to cover the entire affected area lightly, once daily.
When using Clindoxygel for acne and bacterial skin infections, it is essential to consider the potential contraindications, including a history of hypersensitivity to preparations containing clindamycin or lincomycin, a history of regional enteritis or ulcerative colitis, or a history of antibiotic-associated colitis 1. The efficacy of Clindoxygel has been demonstrated in a 12-week controlled clinical trial, where 1% topical clindamycin gel applied once daily was more effective than the vehicle applied once daily 1.
Some key points to consider when using Clindoxygel include:
- Contraindications: history of hypersensitivity to preparations containing clindamycin or lincomycin, history of regional enteritis or ulcerative colitis, or history of antibiotic-associated colitis
- Potential adverse effects: severe colitis, dermatitis, folliculitis, photosensitivity reaction, pruritus, erythema, dry skin, and peeling
- Interactions: Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents
- Pregnancy category: B
- Nursing: it is not known whether clindamycin is excreted in human milk
- Pediatric use: safety and effectiveness have not been established in children <12 years of age 1.
It is crucial to weigh the potential benefits and risks of Clindoxygel, considering the patient's individual circumstances and medical history, to ensure the best possible outcome in terms of morbidity, mortality, and quality of life.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Mechanism of Action The mechanism of action of clindamycin in treating acne vulgaris is unknown. INDICATIONS AND USAGE Clindamycin Phosphate Topical Solution, Clindamycin Phosphate Gel, and Clindamycin Phosphate Lotion are indicated in the treatment of acne vulgaris.
The treatment protocol for Clindoxygel (clindamycin) for acne is to apply the topical solution, gel, or lotion as indicated by the physician.
- The drug label does not provide a specific treatment protocol for bacterial skin infections. The mechanism of action of clindamycin in treating acne vulgaris is unknown 2. Clindamycin is indicated in the treatment of acne vulgaris 2.
From the Research
Treatment Protocol for Clindoxygel (Clindamycin)
- Clindoxygel, a combination of 1% clindamycin phosphate and 5% benzoyl peroxide, is used for the treatment of acne vulgaris and has been shown to be more efficacious than either active agent alone or the vehicle in reducing lesion counts and improving global scores in patients with moderate acne 3.
- The treatment protocol for Clindoxygel typically involves once-daily application, as approved in Canada in 2001 3.
- Topical clindamycin has been found to be superior in efficacy compared to erythromycin and tetracycline in the treatment of acne vulgaris, but the emergence of resistance among propionibacteria to both erythromycin and clindamycin is a concern 4.
- Combination topical therapies, such as topical retinoid, benzoyl peroxide, or azelaic acid plus clindamycin, are recommended to preserve the efficacy of clindamycin and prevent resistance 4.
- Clindamycin has been used as a topical, oral, or injectable formulation for over five decades, primarily against gram-positive and anaerobic bacteria, and has been found to have anti-inflammatory and antibiotic mechanisms 5.
- The combination of benzoyl peroxide and clindamycin has been shown to be more effective than either individual agent used alone, with a similar tolerability profile to benzoyl peroxide alone 6.
- Clinical experience has demonstrated the efficacy and safety of clindamycin 1% benzoyl peroxide 5% gel as monotherapy and in combination with other acne treatments, with improvement noted through photographic, physician, and/or patient assessments 7.