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 staphylocci Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin hydrochloride and other antibacterial drugs, clindamycin hydrochloride should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
Second line antibiotics for cat bite treatment may include clindamycin, as it is effective against susceptible strains of streptococci, staphylococci, and anaerobic bacteria, which can be present in cat bites. However, bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Clindamycin should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria 1.
- Key points:
- Clindamycin is effective against susceptible strains of streptococci, staphylococci, and anaerobic bacteria
- Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin
- Clindamycin should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria
From the Research
For cat bite infections that are not responding to initial antibiotic therapy, second-line antibiotics typically include a beta-lactam/beta-lactamase inhibitor combination such as amoxicillin-clavulanate (875/125 mg twice daily for 5-7 days) or ampicillin-sulbactam (1.5-3 g IV every 6 hours for hospitalized patients). The choice of second-line antibiotics is crucial in managing cat bite infections, especially when Pasteurella multocida is suspected, as it is a common cause of infection in cat bites 2. Some key points to consider in the management of cat bite infections include:
- The use of fluoroquinolones like levofloxacin (750 mg daily) or moxifloxacin (400 mg daily) as alternative second-line options 3
- The recommendation of clindamycin (300-450 mg three times daily) plus either trimethoprim-sulfamethoxazole (1-2 DS tablets twice daily) or a fluoroquinolone for patients with penicillin allergies 4
- The importance of adjusting treatment based on culture results when available, as cat bites often contain polymicrobial infections including aerobic bacteria (particularly Pasteurella multocida) and anaerobes 5
- The need for proper wound care, including thorough irrigation, debridement of devitalized tissue, and tetanus prophylaxis if needed, in addition to antibiotic therapy 6 Patients should be monitored for signs of treatment failure, such as increasing pain, redness, swelling, or drainage, which may indicate the need for further medical attention 2.