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DERMATOLOGICALS › ANTI-ACNE PREPARATIONS › ANTI-ACNE PREPARATIONS FOR TOPICAL USE › Antiinfectives for treatment of acne
clindamycin
D10AF01
Forms & Strengths
- Capsule: 75 mg, 150 mg, 300 mg (as clindamycin hydrochloride)
- Injection: 150 mg/mL (as clindamycin phosphate)
- Oral Solution: 75 mg/5 mL (as clindamycin palmitate hydrochloride)
- Topical Gel: 1% (as clindamycin phosphate)
- Topical Solution: 1% (as clindamycin phosphate)
- Topical Lotion: 1% (as clindamycin phosphate)
- Topical Foam: 1% (as clindamycin phosphate)
- Vaginal Cream: 2% (as clindamycin phosphate)
- Vaginal Ovules/Suppositories: 100 mg (as clindamycin phosphate)
Adult Dosing
- Serious infections (oral): 150 mg to 300 mg every 6 hours; up to 450 mg every 6 hours for severe infections
- Severe infections (parenteral): 600 mg to 1200 mg intravenously or intramuscularly divided into 2, 3, or 4 equal doses daily
- Life-threatening infections (parenteral): Up to 2700 mg to 4800 mg daily in divided doses
- Acne vulgaris (topical): Apply a thin film twice daily to affected areas
- Bacterial vaginosis (vaginal): One 100 mg suppository intravaginally once daily at bedtime for 3 days, or one applicatorful of 2% cream (100 mg) intravaginally at bedtime for 7 days
Pediatric Dosing
- Serious infections (oral, pediatric > 1 month): 8 to 16 mg/kg/day divided into 3 or 4 equal doses
- Severe infections (oral, pediatric > 1 month): 16 to 20 mg/kg/day divided into 3 or 4 equal doses
- Severe/Life-threatening infections (parenteral, pediatric > 1 month): 20 to 40 mg/kg/day in 3 or 4 equal doses
- Acne vulgaris (topical, pediatric >= 12 years): Apply a thin film twice daily to affected areas
Indications
- Treatment of serious infections caused by susceptible anaerobic bacteria, streptococci, staphylococci, and pneumococci
- Skin and skin structure infections
- Intra-abdominal infections (peritonitis and intra-abdominal abscess)
- Lower respiratory tract infections (empyema, anaerobic pneumonia, and lung abscess)
- Septicemia
- Bone and joint infections
- Topical: Treatment of acne vulgaris
- Vaginal: Treatment of bacterial vaginosis
Mechanism of Action
- Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit
- Primarily bacteriostatic, but can be bactericidal in high concentrations against sensitive organisms
Contraindications
- History of hypersensitivity to clindamycin or lincomycin
- History of regional enteritis (crohn's disease), ulcerative colitis, or antibiotic-associated colitis
Adverse Reactions
- Clostridioides difficile-associated diarrhea (CDAD) ranging from mild diarrhea to severe colitis
- Nausea, vomiting, abdominal pain, and esophagitis
- Maculopapular rash and urticaria
- Injection site reactions (pain, thrombophlebitis with IV administration)
- Transient elevated liver function tests (AST, ALT)
- Topical use: Dryness, burning, erythema, pruritus, and oiliness of the skin
- Vaginal use: Vulvovaginitis, vaginal candidiasis, and trichomoniasis
Drug Interactions
- Neuromuscular blocking agents: Clindamycin enhances neuromuscular blockade, potentially leading to respiratory depression
- Erythromycin: Antagonism in vitro; avoid concurrent use due to competitive binding at the 50S ribosomal subunit
- CYP3A4 inhibitors/inducers: Clindamycin is metabolized primarily by CYP3A4 and CYP3A5; strong inducers may decrease efficacy
Curated Content: Needs Vetting Before Put to Clinical Use