Clindamycin has a bacteriostatic effect. It is a bacterial protein synthesis inhibitor by inhibiting ribosomal translocation, similar way to macrolides.
Clindamycin may prolong the effects of neuromuscular-blocking drugs
Clindamycin is used primarily to treat anaerobic including dental, respiratory tract, skin, and soft tissue, and peritonitis.
In hypersensitivity topenicillins, may be used to treat aerobicbacteria, in bone and joint, particular Staphylococcus aureus.
Topical application of clindamycin phosphate can be used to treat mild to moderate acne.
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.
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.
Clindamycin may be useful in skin and soft tissue MRSA
Clindamycin is used in cases of suspected toxic shock syndrome, often in combination synergistically with a bactericidal agent such asvancomycin. Both in vitro and in vivo studies have shown clindamycin reduces the production of exotoxins by staphylococci; it may also induce changes in the surface structure of bacteria that make them more sensitive to immune system attack (opsonization and phagocytosis).
Given with chloroquine or quinine, clindamycin is effective and well tolerated in treating Plasmodium falciparum malaria; the latter combination is particularly useful for children, and is the treatment of choice for pregnant women who become infected in areas where resistance to chloroquine is common
The combination of clindamycin and quinine is the standard treatment for severe babesiosis.
Clindamycin may also be used to treat toxoplasmosis,[and, in combination with primaquine, is effective in treating mild to moderate Pneumocystis jirovecii pneumonia.
Common adverse drug reactions associated with clindamycin therapy — found in over 1% of patients — include: diarrhea,pseudomembranous colitis, nausea, vomiting, abdominal pain or cramps, rash, and/or itch. High doses (both intravenous and oral) may cause a metallic taste, and topical application may cause contact dermatitis.
Pseudomembranous colitis -Overgrowth of Clostridium difficile, which is inherently resistant to clindamycin
Rarely — in less than 0.1% of patients — clindamycin therapy has been associated with anaphylaxis, blood dyscrasias, polyarthritis,jaundice, raised liver enzyme levels, and/or hepatotoxicity.
