clindamycin (Cleocin, Cindesse, ClindaMax)
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Introduction
Tradename: Cleocin.
Indications
- Gm+ aerobic or anaerobic bacterial infections
- alternative agent in treatment of
- malaria
- toxoplasmosis (with pyrimethamine)
- Pneumocystis carinii (with primaquine)
- babesiosis
- empiric treatment for fever of unknown origin[8]
- prophylaxis for bacterial endocarditis
- prophylaxis for perioperative infection
- topical treatment of rosacea & severe acne
- intravaginally for treatment of bacterial vaginosis
Contraindications
- not to be used in combination with beta-lactam/ beta-lactamase antibiotics, i.e. Unasyn, Zosyn, Augmentin
Dosage
600-900 mg IV every 8 hours 150-450 mg PO every 6 hours.
100 mg (1 full applicator) inserted intravaginally QHS for 7 days. Clindesse: 100 mg one time application (2% cream)[7]
Cream: 2% 20 mg/g (40 g) "
Gel: 10 mg/g (7.5 g, 30 g) (as phosphate)
Solution: topical 1% (60 mL) "
Injection: 150 mg/mL (2, 4, 6 mL) "
Tabs: 150 mg (as hydrochloride)
Topical agent for acne:
- apply thin film BID
- maximum benefit may not be seen for 12 weeks
Pharmacokinetics
- well absorbed orally
- distributes to most body fluids & bone
- poor CSF penetration
- metabolized by the liver
- eliminated in the bile, urine & feces
- 1/2life 2-3 hours
- concentration slightly altered by dialysis
, 10% of topically applied drug is absorbed systemically.
elimination via liver
1/2life = 1.6-5.3 hours
protein binding = 94 %
Antimicrobial activity
Adverse effects
- common (> 10%)
- less common (1-10%)
- uncommon (< 1%)
- thrombophlebitis, hypotension, urticaria, Stevens-Johnson syndrome, eosinophilia, neutropenia, granulocytopenia, thrombocytopenia, increased serum transaminases, sterile abscess at IM injection site, polyarthritis, renal dysfunction (rare)
- topical
- rash, hypersensitivity, dryness of skin
- Clindesse weakens latex condoms & diaphragms for 5 days
Drug interactions
- clindamycin may enhance activity of neuromuscular blocking agents
- do NOT take with erythromycin
- kaolin-pectin incombination reduces clindamycin levels; take 2 hours apart
Mechanism of action
- binds to 50S ribosomal subunit inhibiting bacterial protein synthesis
- bacteriostatic
More general terms
Component of
- adapalene/clindamycin
- benzoyl peroxide/clindamycin/phosphate
- all trans retinoic acid/clindamycin/phosphate
- all trans retinoic acid/clindamycin
- benzoyl peroxide/clindamycin (BenzaClin)
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 166.
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Sanford Guide to antimicrobial therapy 1997
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ 7.0 7.1 Prescriber's Letter 12(2): 2005 Clindesse (Clindamycin Vaginal Cream, 2%) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210213&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 8.0 8.1 8.2 Deprecated Reference
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=4446598
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=29029
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2786
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=32603
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=443385
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=30644
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=656713
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=33030
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=358642
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=83855