Clindamycin: uses and indications

Clindamycin It is a semi-synthetic antibiotic that belongs to the group of lincosamides. It is a drug with bacteriostatic activity.

It is used to treat certain types of bacterial infections, including infections of the lungs, skin, blood, women's reproductive organs, as well as internal organs.

How does clindamycin work?

This broad-spectrum antibiotic from the lincosamide group It has a mainly bacteriostatic activity. It acts against gram positive aerobic bacteria and against many anaerobic bacteria.

Clindaminin exerts its action by binding to the 50S subunit of the bacterial ribosome. In this way, it inhibits the first stages of protein synthesis of the bacterial cell.

Although its action is primarily bacteriostatic, at high concentrations it can have a bactericidal effect. This will depend on the sensitivity of the strain and the medium.

Administered orally, almost 90% of the dose is absorbed. Although it is not known how much, it takes food together, delays this absorption.

Therapeutic indications of clindamycin

This drug It is indicated in the treatment of infections caused by sensitive microorganisms. They are between them:

Since some of these infections are often also caused by gram-negative bacilli, clindamycin is used with other additional antibiotics. Topically, It is used for the treatment of acne.

However, It can be used to treat infections by clindamycin or erythromycin sensitive strains. It can also happen that some strains are sensitive to one of the antibiotics and resistant to the other.

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Adverse effects

The main adverse effect of clindamycin is diarrhea associated with Clostridium difficile. It is associated with this type of diarrhea in up to 10% of patients under treatment, regardless of the route of administration, including the topical route.

Hypersensitivity reactions may also occur. When administered orally, if not taken with water, it can cause esophagitis.

On the other hand, other adverse side reactions may also appear in patients under treatment with clindamycin, among which are:

  • Hematological: There have been cases of severe leukopenia, leukocytosis, anemia and thrombocytopenia.
  • Cardiovascular system: In some patients, clindamycin can cause severe arrhythmias such as ventricular fibrillation, lengthening of the QT interval and polymorphic ventricular arrhythmia.
  • Central Nervous System: It is possible that there are isolated events of neuromuscular block.
  • Gastrointestinal: Treatment with clindamycin can cause diarrhea, nausea, vomiting and abdominal pain. In addition, it can induce pseudomembranous colitis by superinfection due to Clostridium difficile. This effect is reversible if treatment is suspended. Having to use supportive measures together with the administration of vancomycin or metronidazole.
  • Liver: This antibiotic may raise the levels of aspartate aminotransferase and alanine aminotransferase, as well as bilirubin concentrations due to direct liver damage.
  • Kidney and genitourinary tract: It is associated with clindamycin with pictures of vaginal moniliasis and vulvovaginitis.
  • Skin: There are cases in which the appearance of rash can be observed, which can be of mild to moderate intensity.

When the treatment is topical, itching may manifest facial, contact dermatitis, facial edema and maculopapular rash.

Other side effects that may occur in people treated with clindamycin include the Stevens-Johnson syndrome, hypersensitivity reactions in HIV positive patients and lymphadenitis. However, these reactions are rare.

Contraindications

Clindamycin is contraindicated in patients with a history of allergic reactions to this drug and to lincomycin.

As for breastfeeding, you should know that this drug is excreted in breast milk. For this reason, and due to the possible serious effects on the infant, its use during the same is contraindicated. It should also not be used during pregnancy, unless strictly necessary, since there are not enough studies or data.

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conclusion

Numerous clinical trials and extensive pharmacovigilance experience endorse the use of clindamycin as an effective drug in the treatment of oral maxillofacial infections, among others.

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