CLINDAMYCIN

CATEGORY: ANTIBIOTIC

INTRODUCTION:

Clindamycin is an FDA-approved antibiotic used to treat bacterial infections. Clindamycin is also commonly used for uncomplicated skin and soft-tissue infections. It is also used to treat acne, intra-abdominal infections, skin structure infections, post-operative infections, and pelvic inflammatory disease. Clindamycin is also used in the treatment of babesiosis, anthrax, and malaria.

Uses:

How to Consume:

Take clindamycin as directed by your doctor. The dosage form and amount of the drug may vary for each infection. Clindamycin can be administered to the body in several ways. Clindamycin can be taken orally with a glass of water to prevent irritation of the esophagus and can be taken with or without food. Clindamycin is given intravenously and intramuscularly.

It is also available topically as a foam, gel, lotion, or solution to treat acne vulgaris. The thin film should be applied twice daily or as directed by your doctor. It is available in the form of creams and suppositories for vaginal administration to treat bacterial vaginosis.

Storage:

Store the medication in an airtight container at room temperature, keep away from heat, moisture, and direct sunlight. Do not freeze.

Duration Between Two Doses:

Clindamycin is taken orally i.e., 150 mg to 300 mg every 6 hours, and for severe infections it is 300 mg to 450 mg every 6 hours. Inject 2 to 4 times daily. The amount of both dosage forms depends on the infection (severity of the infection).

Side Effects:

• Stomach pain

• Diarrhea

• Nausea or vomiting

• Disgusting, metallic taste in the mouth

• Rash and itching

• Joint pain

• Pain when swallowing

• Irritation at the Injection site

Stomach pain: side effects

Drug Mechanism:

Pharmacokinetics:

Studies show that clindamycin does not accumulate in the serum and is rapidly cleared in neonates and infants up to 6 months of age. It is widely distributed in the body, including bone, but not in cerebrospinal fluid. Its protein binding is concentration-dependent and mainly binds to α-1-acid glycoprotein in serum. It is metabolized by CYP3A4 in the liver and CYP3A5 in the liver.

Pharmacodynamics:

Clindamycin is a drug that inhibits bacterial protein synthesis by binding to the 505 ribosomal subunit, thereby preventing bacterial growth. It has both a bacteriostatic and bactericidal effect depending on the active substance concentration, organism, and infection site. It is effective against both Gram-positive and Gram-negative anaerobes and is found in the body, including bone, but not in cerebrospinal fluid.

Safety Measures:

When to See Doctor:

Some common side effects may be seen after taking/using Clindamycin. Side effects may be normal, but if the symptoms are severe, talk to your doctor right away.

• Hives

• skin rashes and itching;

• Difficulty breathing or swallowing

• yellowing of the skin and eyes;

• Decreased urination

• Peeling or blistering skin

• thick white discharge

• Vaginal burning, itching, swelling

• Heartburn

• White spots inside the mouth

• Swelling on the face, throat, tongue, lips, eyes, hands, feet, ankles, or legs.

Allergic Reaction:

Clindamycin can cause severe allergic reactions. Tell your doctor if you have or ever had asthma, allergies, eczema (sensitive skin that often itches and irritates), or kidney or liver disease.

Symptoms are:

• Heartburn

• Oral candidiasis

• Vaginal yeast infection

• White spots inside the mouth

• Dark urine

Available Dosage Forms:

Form:

1. Capsule

Strength : 150 mg

2. Injection (Store Below 300 C and shouldn’t be refrigerated or frozen)

Strength : 150 mg/ml

Child Dosage:

Infant – less than 28 days

The dose is 15-20 mg/kg injection (IM/IV) per day over 6-8 hours. Lower doses may be sufficient for small preterm infants.

Under 10kg:

Recommended minimum dose: 37.5 mg orally 3 times daily.

From 11 kg weight:

Severe infection: 8-12 mg/kg orally daily in 3-4 equal doses.

Body Surface Dose:

Severe infection: 350 mg/m2 per day by IV infusion or IM injection

More Severe infection: 450 mg/m2 per day by IV infusion or IM injection.

From 1 month to 16 years:

Inject 8 to 40 mg/kg a day in 3 to 4 divided doses, and inject 20 to 40 mg/kg a day. Higher doses are used for more serious infections.

Adult Dosage:

Dosage for Adults (17 years and older) –

Orally-

Severe infection: 150–300 mg orally every 6 hours.

More serious infections: 300–450 mg orally every 6 hours.

Parenterally:

Severe infection: 600 to 1,200 mg daily by IV or IM injection in 2 to 4 divided doses.

More Severe infection: Intravenous or intramuscular injection of 1,200 to 2,700 mg per day in 2 to 4 divided doses.

Important Note:

• If you plan to have surgery, including dental surgery, tell your doctor or dentist that you are taking clindamycin.

• Continue to eat normally unless directed otherwise by your doctor.

• After missing a dose, skip it and carry on with your regular dosing schedule. You should not take two doses to make up for missed doses.

• Tell your doctor if you are allergic to aspirin or tartrazine if you are taking clindamycin capsules.

• Tell your doctor if you have or have had asthma, allergies, eczema (sensitive skin that is often itchy and inflamed), or kidney or liver disease.

• Do not let anyone take your medicine. Your prescription is probably not refillable. If you stop treatment with clindamycin and symptoms of infection persist, talk to your doctor.

• Tell your doctor if you experience severe or persistent diarrhea while on clindamycin or within a few months of stopping clindamycin.

• Take as directed and for the intended duration. Complete prescribed treatment.

Available brands:

Reference:

• Indian Pharmacopeia

• Book Of Rang & Dale’s Pharmacology (9th Edition)

• Book Of Essentials of Medical Pharmacology – K D Tripathi (8th edition)

• https://www.drugs.com/tips/clindamycin-patient-tips#tips

• https://medlineplus.gov/druginfo/meds/a682399.html

• https://www.ncbi.nlm.nih.gov/books/NBK519574/

• https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=0800afad-e4cd-4f70-aaa1-a14547be4729