From the Guidelines
Clindamycin is a recommended antibiotic for the treatment of skin and soft tissue infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA) and anaerobic bacteria, with a typical adult dosage ranging from 150-450 mg orally every 6-8 hours, or 600-900 mg intravenously every 8 hours, as stated in the guidelines by the Infectious Diseases Society of America 1.
Key Points
- Clindamycin works by inhibiting bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing the formation of peptide bonds.
- It is commonly prescribed for skin and soft tissue infections, bone and joint infections, dental infections, pelvic inflammatory disease, and as an alternative for patients with penicillin allergies.
- The treatment duration typically ranges from 7-14 days based on the type and severity of infection.
- Common side effects include diarrhea, nausea, and rash, and clindamycin carries a risk of Clostridioides difficile-associated diarrhea (CDAD).
- Clindamycin should be used cautiously in patients with a history of gastrointestinal disease, liver or kidney impairment, and should not be used in those with a history of hypersensitivity to lincosamide antibiotics.
Dosage and Administration
- The typical adult dosage ranges from 150-450 mg orally every 6-8 hours, or 600-900 mg intravenously every 8 hours, depending on the severity of infection.
- For children, the dosage is usually 8-25 mg/kg/day divided into 3-4 doses.
Indications and Usage
- Clindamycin is recommended for the treatment of skin and soft tissue infections, including abscesses, cellulitis, and infected ulcers and burns, as stated in the guidelines by the Infectious Diseases Society of America 1.
- It is also recommended for the treatment of necrotizing fasciitis and streptococcal toxic shock syndrome caused by group A streptococci, in combination with penicillin, as stated in the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1.
From the FDA Drug Label
Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate.
Indications for Clindamycin:
- Serious infections caused by susceptible anaerobic bacteria
- Serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci
- Reserved for penicillin-allergic patients or when a penicillin is inappropriate 2 Key Points:
- Clindamycin is bacteriostatic and inhibits bacterial protein synthesis by binding to the 23S RNA of the 50S subunit of the ribosome 2
- Resistance to clindamycin is most often caused by modification of specific bases of the 23S ribosomal RNA 2
From the Research
Clindamycin Overview
- Clindamycin is an antibiotic that has been used for over 20 years in the treatment of obstetric and gynecologic infections 3.
- It is known for its activity against anaerobic bacteria, particularly beta-lactamase-producing strains of the Bacteroides species 3.
- Clindamycin also has good activity against aerobic gram-positive cocci, such as group B streptococci, but lacks activity against aerobic gram-negative rods, such as E. coli 3.
Clinical Uses
- Clindamycin is used in the treatment of specific anaerobic infections, as well as clinical situations where both S. aureus and anaerobes occur together 4.
- It is effective in the treatment of pleuropulmonary and intra-abdominal infections caused by anaerobic bacteria 5.
- Clindamycin is also used in the therapy and prophylaxis of bacterial, protozoal, and fungal infections, including those caused by Toxoplasma gondii, Plasmodium falciparum, Babesia spp., and Pneumocystis jiroveci 6.
Resistance and Limitations
- Clindamycin resistance is a growing concern, with an increasing number of microorganisms developing resistance to this antibiotic 6.
- The choice of clindamycin as a treatment option depends on the organisms responsible for the infection, as well as pharmacologic characteristics, degree of bactericidal activity, and toxicity 7.
- Clindamycin is not effective against all types of bacteria, and its use should be guided by in vitro susceptibility tests and clinical judgment 7.