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Clindamycin (Cleocin)

Clindamycin

KEY POINTS

  • Clindamycin (Cleocin) is a lincosamide antibiotic, which inhibits protein synthesis in susceptible bacteria by binding to the 50S ribosomal subunit
  • Available as injectable, oral and topical
    • Typical oral dose is 150 to 450 mg per DOSE every 6 hrs
    • Typical IV dose is 600 to 2,700 mg per DAY divided in 2 to 4 doses
  • Has activity versus Gram positive organisms like Streptococcus species and Staphylococcus species
    • Typically covers community-associated MRSA but not health care-associated MRSA
  • Has activity versus anaerobic organisms, but not versus Clostridium difficile
    • Not great for Bacteroides fragilis
  • Has the ability to inhibit bacterial toxin synthesis
    • At times added to other agents for this purpose in the treatment of necrotizing staphylococcal or streptococcal infections
  • Commonly considered for use when a beta-lactam is not an option (e.g., penicillin allergy present)
  • Has many uses, including surgical prophylaxis, skin and soft tissue infections, community acquired pneumonia and more
  • Highly associated with Clostridium difficile infection
    • Even has a U.S. Boxed Warning of: “Can cause severe and possibly fatal colitis”
  • The D Test is use with clindamycin to test for inducible resistance in MRSA

D Test

Photo Credit: www.microbeonline.com (click the pic for their article)

RESOURCES

  • IV Clindamycin Package Insert
  • Oral Clindamycin Package Insert
  • 2015 CDC STD Guideline
  • IDSA Practice Guidelines
  • Comparison of CA-MRSA and HA-MRSA
  • Ways to Improve Insights into Clindamycin Pharmacology and Pharmacokinetics Tailored to Practice
  • Clindamycin versus Trimethoprim–Sulfamethoxazole for Uncomplicated Skin Infections
  • Increasing clindamycin resistance in group A streptococcus
  • Clindamycin STAT Pearls

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Study Guide

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  • Sotrovimab (Xevudy)
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  • Tecovirimat (TPOXX)
  • Tedizolid (Sivextro)
  • Telavancin (Vibativ)
  • Tigecycline (Tygacil)
  • Tobramycin
  • Tocilizumab (Actemra)
  • Valacyclovir (Valtrex)
  • Valganciclovir (Valcyte)
  • Vancomycin
  • Voriconazole (VFend)
  • Zidovudine (Retrovir)
  • Zoster vaccine recombinant, adjuvanted (Shingrix)

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