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Clindamycin

Intravenous
Intramuscular
Intravaginal
Topical
Class
Antibiotics
Subclass
Lincosamides
Substance name
Clindamycin
Brand names
Clindagel®
Common formulations
Gel
See also
Clindamycin hydrochloride (Cleocin®)
Dosage and administration
Indications for use
Labeled indications
Adults
•
Treatment of intra-abdominal abscess (due to anaerobic pathogens)
•
Treatment of lower respiratory tract infections (anaerobic causative agent, serious)
•
Treatment of lower respiratory tract infections (serious infections, anaerobic causative agent)
•
Treatment of sepsis (anaerobic causative agent)
•
Treatment of septicemia (severe, anaerobic causative agent)
•
Treatment of SSTIs (anaerobic causative agent, severe)
•
Treatment of SSTIs (caused by S. aureus)
Children
•
Treatment of bacterial infections (in patients 1 month to 16 years) (serious, caused by susceptible anaerobs, streptococci, staphylococci, or pneumococci)
•
Treatment of bacterial infections (in patients < 1 month) (serious, caused by susceptible anaerobs, streptococci, staphylococci, or pneumococci)
Safety risks
Boxed warnings
C. difficile infection, antibiotic-associated diarrhea
•
do not use in patients with nonbacterial infections such as most upper respiratory tract infections.
Contraindications
Hypersensitivity to clindamycin or its components
Warnings and precautions
Decreased CSF clindamycin levels
•
Use extreme caution in patients with meningitis.
Exacerbation of nephrotoxicity
•
Use caution in patients with pre-existing renal dysfunction or those taking concomitant nephrotoxic drugs.
Gasping syndrome
•
Use caution in neonates.
Toxic epidermal necrolysis, anaphylactic shock, Stevens-Johnson syndrome
•
Use caution in all patients.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required.
Renal replacement therapy
Any modality
•
Use acceptable. No dose adjustment required.
Hepatic impairment
Child-Pugh A (mild)
•
Use acceptable. No dose adjustment required.
Child-Pugh B (moderate)
•
Use acceptable. No dose adjustment required.
Child-Pugh C (severe)
•
Use with caution.
Pregnancy and breastfeeding
Breastfeeding
Consider alternative agents that may be safer.
Unknown drug levels in breastfed infants.
May potentially cause adverse effects in breastfed infants.
Adverse reactions
Very common > 10%
•
Candidiasis, dry skin patches, diarrhea, generalized pruritus, skin erythema
Common 1-10%
•
Acute generalized exanthematous pustulosis, DRESS syndrome, hyperthyroidism, abdominal pain, back pain, constipation, dizziness, dysmenorrhea, dyspepsia, dysuria, fatigue, fever, flatulence, headache, nausea, nosebleed, pelvic pain, vertigo, vomiting, toxic epidermal necrolysis, vaginitis
Unknown frequency
•
Agranulocytosis, anaphylaxis, angioedema, Clostridioides difficile infection, cardiac arrest, contact dermatitis, ↓ WBC count, ↓ blood neutrophil count, ↓ platelet count, erythema multiforme, esophagitis, exfoliative dermatitis, hypotension, ↑ liver enzymes, jaundice, maculopapular rash, phlebitis, pseudomembranous colitis, dysgeusia, dysphagia, eye irritation, eye pain, halitosis, injection site reactions, odynophagia, vaginal bleeding, seborrheic dermatitis, Stevens-Johnson syndrome, urticaria
Interactions
Drug(s)
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