Contraindications and Precautions for Clindamycin Use

Absolute Contraindications

The American Academy of Dermatology recommends 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 (including pseudomembranous colitis) 1, 2
Clindamycin is contraindicated in patients with a history of regional enteritis (Crohn's disease) 1, 3
Clindamycin is contraindicated in patients with a history of ulcerative colitis 1, 3
Clindamycin is contraindicated in patients with a history of antibiotic-associated colitis, including pseudomembranous colitis 1, 3

Caution is advised when using clindamycin in patients with neuromuscular diseases as it has neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents 1, 3
Clindamycin should not be used in combination with erythromycin-containing products due to antagonistic interaction 3, 4
Clindamycin should not be used in combination with other medications with strong neuromuscular blocking effects 1, 3

The American Academy of Dermatology categorizes clindamycin as Pregnancy Category B, indicating it is relatively safe but benefits must outweigh risks 1, 3
Caution is advised when using clindamycin in nursing women as it is not known whether clindamycin is excreted in human milk 1, 3
The safety and effectiveness of clindamycin have not been established in children under 12 years of age for topical formulations 1, 3
A benefit-risk assessment should be performed before using clindamycin in pediatric populations 1, 3

Severe colitis can occur during treatment or even weeks after discontinuation of clindamycin therapy 1
Dermatologic reactions, including dermatitis, folliculitis, photosensitivity reactions, pruritus, erythema, dry skin, and peeling, can occur with clindamycin use 1, 3

The American Academy of Dermatology recommends evaluating gastrointestinal history, including screening for history of inflammatory bowel disease and assessing for previous episodes of antibiotic-associated colitis, before using clindamycin 1, 3