Clindamycin is an antibiotic used for the treatment of a number of bacterial infections, including bone or joint infections, pelvic inflammatory disease, strep throat, pneumonia, middle ear infections, and endocarditis. It can also be used to treat acne, and some cases of methicillin-resistant Staphylococcus aureus (MRSA). In combination with quinine, it can be used for malaria.It is available by mouth, by injection into a vein, and as a cream to be applied to the skin or in the vagina.
Common side effects include nausea, diarrhea, rash, and pain at the site of injection.It increases the risk of hospital-acquired Clostridium difficile colitis about fourfold and thus is only recommended when other antibiotics are not appropriate. Alternative antibiotics may be recommended as a result. It appears to be generally safe in pregnancy. It is of the lincosamide class and works by blocking bacteria from making protein.
Clindamycin was first made in 1966 from lincomycin. It is on the World Health Organization’s List of Essential Medicines. It is available as a generic medication. In 2017, it was the 137th most commonly prescribed medication in the United States, with more than four million prescriptions
Clindamycin is used primarily to treat anaerobic infections caused by susceptible anaerobic bacteria, including dental infections, and infections of the respiratory tract, skin, and soft tissue, and peritonitis. In people with hypersensitivity to penicillins, clindamycin may be used to treat infections caused by susceptible aerobic bacteria, as well. It is also used to treat bone and joint infections, particularly those caused by Staphylococcus aureus. Topical application of clindamycin phosphate can be used to treat mild to moderate acne.
For treatment of acne, in the long term the combined use of topical clindamycin and benzoyl peroxide was similar to salicylic acid plus benzoyl peroxide. Topical clindamycin plus topical benzoyl peroxide is more effective than topical clindamycin alone.
It is most effective against infections involving the following types of organisms:
- Aerobic Gram-positive cocci, including some members of the Staphylococcus and Streptococcus (e.g. pneumococcus) genera, but not enterococci.
- Anaerobic, Gram-negative rod-shaped bacteria, including some Bacteroides, Fusobacterium, and Prevotella, although resistance is increasing in Bacteroides fragilis.[medical citation needed]
Most aerobic Gram-negative bacteria (such as Pseudomonas, Legionella, Haemophilus influenzae and Moraxella) are resistant to clindamycin, as are the facultative anaerobic Enterobacteriaceae. A notable exception is Capnocytophaga canimorsus, for which clindamycin is a first-line drug of choice.
The following represents MIC susceptibility data for a few medically significant pathogens.
- Staphylococcus aureus: 0.016 μg/ml – >256 μg/ml
- Streptococcus pneumoniae: 0.002 μg/ml – >256 μg/ml
- Streptococcus pyogenes: <0.015 μg/ml – >64 μg/ml