Indications
Clindamycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci: upper respiratory tract infections, lower respiratory tract infections, skin and soft tissue infections, bone and joint infections, pelvic infections, intra-abdominal infections, septicemia and endocarditis, dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.
Pharmacology
Clindamycin is a lincosamide antibiotic. Clindamycin inhibits bacterial protein synthesis by binding to the 50S subunit of the ribosome. It has activity against aerobic gram-positive cocci, including: Staphylococcus aureus, Staphylococcus epidermidis (penicillinase and non-penicillinase producing strains), Streptococci, Pneumococci. Anerobic gram-negative bacilli including; Bacteroids species, Fusobacterium species. Anaerobic gram-positove non-spore forming bacilli including: Propionibacterium species, Eubacterium species, Actinomyces species, Peptostreptococcus species, Microaerophillic streptococci, C. perferinges.
Dosage
Dosage of Clindamycin capsule & suspension-Adults:Serious infections: 150 mg-300 mg every six hours.More severe infections: 300 mg-450 mg every six hours.Pediatric PatientsSerious infections: 8-16 mg/kg/day divided into three or four equal doses.More severe infections: 16-20 mg/kg/day divided into three or four equal doses.Dosage of Clindamycin IM/IV Injection-Adults:Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2-4 equal doses.More severe infections: 1200 - 2700 mg/day in 2 - 4 equal doses.For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes these doses may be increased. Doses of as much as 4800 mg daily have been given intravenously to adults.Single intramuscular injections of greater than 600 mg are not recommended.Neonates (less than 1 month):15 to 20 mg/kg/day in 3 to 4 equal doses. The lower effective dosage may be adequate for small premature.Pediatric patients (1 month of age to 16 years):Parenteral (IV/IM) administration: 20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician. In cases of -hemolytic streptococcal infections, treatment should be continued for at least 10 days.
Interaction
Clindamycin enhance the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents. Antagonism has been demonstrated between Clindamycin and Erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.
Contraindications
Clindamycin is contraindicated in patients previously found to be sensitive to Clindamycin or lincomycin or any of the ingredients of this medicine.
Side Effects
The adverse effects have been reported with the use of Clindamycin are abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhea, pruritus, skin rashes and urticaria.
Precautions
Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
Pediatric Use
Use in newborns and infants: When Clindamycin is administered to newborns and infants (birth to 16 years), appropriate monitoring of organ system functions is desirable.
Overdose Effects
Overdosage with orally administered Clindamycin has been rare. Adverse reactions similar to those seen with normal doses can be expected, however, unexpected reactions could occur. Haemodialysis and peritoneal dialysis are not effective in removing Clindamycin from the serum. Overdosage should be treated with simple gastric lavage. No specific antidote is known.
Storage Condition
Keep in a dry place away from light and heat. Keep out of the reach of children.