Clindamycin, Dalacin/Cleocin
Description: Antibiotic, Lincosamide
“ALERT: US Boxed Warning
Colitis:
Clostridioides (formerly Clostridium) difficile-associated diarrhea (CDAD) has been reported with the use of nearly all antibacterial agents, including clindamycin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile.
Because clindamycin therapy has been associated with severe colitis, which may end fatally, reserve it for serious infections for which less toxic antimicrobial agents are inappropriate. Do not use clindamycin in patients with nonbacterial infections, such as most upper respiratory tract infections.
C. difficile produces toxins A and B, which contribute to the development of CDAD. Hypertoxin-producing strains of C. difficilecause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary because CDAD has been reported to occur more than 2 months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Institute appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation as clinically indicated.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Clindamycin/Dalacin/Cleocin binds to ribosomal 50S subunits of certain bacteria thereby stopping protein synthesis for the cell eventually resulting in cell death. May be bacteriostatic (prevents reproduction) or bactericidal (directly kills live bacteria) depending on the dosage.
Indications For Use
Clindamycin/Dalacin/Cleocin is used on and off label for various infections depending on your common local bacterial strains for various infections and based on local resistance patterns. Not all antibiotics work for all infections and efficacy can vary from area to area and vary with time. It is common in North America for use in bacterial vaginosis (off-label), diabetic foot infections (off-label), endocarditis prophylaxis (off-label), osteomyelitis, pneumonia (off-label), soft tissue infections, etc.
Precautions
Before starting Clindamycin/Dalacin/Cleocin make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, gastrointestinal disease (e.g. colitis), if you are pregnant, breastfeeding.
Usual Dosing
600mg-2400mg divided into two to four daily doses depending on the condition it is used for
Pharmacist Tips On Using
How to Take: Follow instructions provided by physician/pharmacy label, swallow whole with a whole glass of water, take consistently at same times each unless otherwise directed, store at room temperature. Can be with or without food but the food may reduce the risk of gastrointestinal side effects.
You Need to Avoid: Do not lay down for 15 minutes after dosing to prevent reflux to minimize the risk of esophageal damage.
Side Effects
Rash, abdominal pain, diarrhea, nausea (note this is not a complete list of side effects)
Clindamycin is a broad-spectrum antibiotic (kills many kinds of bacteria) which means it can increase the risk of opportunistic superinfection such as C. difficile associated diarrhea.
Frequently Asked Questions
What do I do if side effects are intolerable?
If side effects are causing a lot of distress speak to your physician as soon as possible to discuss options.