From the Guidelines
Clindamycin is preferred over Augmentin (amoxicillin-clavulanate) for the treatment of skin and soft tissue infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA) or anaerobic bacteria, as recommended by the Infectious Diseases Society of America in 2014 1.
Key Considerations
- Clindamycin is effective against a wide range of gram-positive cocci, including MRSA, and anaerobic bacteria, making it a suitable choice for skin and soft tissue infections where these pathogens are suspected 1.
- Augmentin, on the other hand, is preferred for infections where both gram-positive and gram-negative bacteria are suspected, such as respiratory tract infections or urinary tract infections.
Dosage and Administration
- The typical adult dose of clindamycin is 300-450 mg orally every 6-8 hours, or 600 mg every 8 hours intravenously for severe infections 1.
- Augmentin is typically dosed at 875 mg/125 mg twice daily or 500 mg/125 mg three times daily for 7-10 days, depending on the severity of the infection.
Patient-Specific Factors
- The choice between clindamycin and Augmentin also depends on patient-specific factors, such as allergies, renal function, and concomitant medications.
- Clindamycin has a higher risk of causing Clostridioides difficile (C. diff) infections, while Augmentin can cause more gastrointestinal side effects.
Local Resistance Patterns
- Local resistance patterns should also be considered when selecting between these antibiotics, as the efficacy of each antibiotic can vary depending on the prevalence of resistant organisms in the area 1.
Infection Site and Pathogens
- The specific infection site and likely pathogens should also be taken into account when choosing between clindamycin and Augmentin, as this can affect the likelihood of success with each antibiotic.
From the Research
Preference for Clindamycin over Augmentin
- Clindamycin is preferred over Augmentin (amoxicillin-clavulanate) in the treatment of severe abdominal and female pelvic infections, particularly those involving anaerobic bacteria 2.
- Clindamycin has been shown to be effective in the treatment of obstetric and gynecologic infections, including pelvic inflammatory disease, post-cesarean section endometritis, and posthysterectomy vaginal cuff infections 3.
- Clindamycin is also preferred in the treatment of anaerobic infections, especially when Bacteroides fragilis is not a common isolate, and in cases where high-dose penicillin G therapy is not sufficient 4.
Preference for Augmentin over Clindamycin
- There is no direct evidence in the provided studies to suggest a preference for Augmentin (amoxicillin-clavulanate) over clindamycin in the treatment of specific infections.
- However, it can be inferred that Augmentin may be preferred in cases where aerobic bacteria are the primary cause of infection, as clindamycin's spectrum of activity is limited to anaerobes and gram-positive aerobes other than enterococci 3.
- Additionally, Augmentin may be preferred in cases where the infection is caused by bacteria that are resistant to clindamycin, or in cases where the patient has a history of allergy or intolerance to clindamycin 4, 5, 6.