Clindamycin Mechanism and Clinical Applications

Mechanism of Action and Antimicrobial Spectrum

• Clindamycin acts by binding to the 50S ribosomal subunit of susceptible bacteria, thereby suppressing protein synthesis, and has a concentration-dependent mechanism of antimicrobial activity 1, 2
• It is not active against Haemophilus influenzae and Moraxella catarrhalis, but is effective against many gram-negative anaerobes 1

Clinical Applications and Important Considerations

• The American Academy of Dermatology recommends clindamycin for the treatment of acne vulgaris, and it is used in both topical and oral formulations 3
• Clindamycin is recommended for methicillin-resistant S. aureus (MRSA) infections, and is used for impetigo, purulent and non-purulent skin infections 4, 5
• The Infectious Diseases Society of America notes that clindamycin has excellent tissue penetration, particularly in bone and abscesses, making it suitable for bone and joint infections 6, 7
• Clindamycin may cause diarrhea in up to 20% of patients, and Clostridium difficile-associated disease may occur more frequently compared with other oral agents 6, 7
• The American Academy of Dermatology advises that clindamycin is contraindicated in patients with a history of hypersensitivity to clindamycin or lincomycin, and in those with a history of regional enteritis, ulcerative colitis, or antibiotic-associated colitis 3
• Clindamycin is classified as Category B in pregnancy, according to the Clinical Infectious Diseases guidelines 6, 7

Clindamycin Treatment Guidelines

Clinical Applications

• The Centers for Disease Control and Prevention, as reported in MMWR Recommendations and Reports, recommends clindamycin as an alternative to sulfonamides in patients with toxoplasmosis who develop sulfonamide hypersensitivity 8