Clindamycin

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 infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As alternative therapy when used in combination with quinine or amlodiaquine for the treatment of multi-drug resistant Plasmodium infection.

Therapeutic Class

Miscellaneous Antibiotics

Pharmacology

Clindamycin inhibits protein synthesis by reversibly binding to the 50S ribosomal subunit, thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting to stunted cell growth.

It has activity against-
  • Aerobic gram-positive cocci, including: Staphylococcus aureus, Staphylococcus epidermidis (penicillinase and non-penicillinase producing strains), Streptococci, Pneumococci.
  • Anaerobic gram-negative bacilli including: Bacteroides species, Fusobacterium species.
  • Anaerobic gram-positive non-spore forming bacilli including:
  • Propionibacterium species, Eubacterium species, Actinomyces species.
  • Anaerobic and microaerophilic gram-positive cocci including: Peptococcus species, Peptostreptococcus species, Microaerophilic streptococci, C. perferinges.

Dosage

Oral-
Severe anaerobic infections:
  • Adult: 150-300 mg 6 hourly, up to 450 mg in severe infections. Max: 1.8 g/day.
  • Child: 3-6 mg/kg 6 hourly.
Parenteral-
Severe anaerobic infections:
  • Adult: 0.6-2.7 g daily in 2-4 divided doses, increased to 4.8 g daily in life-threatening infections. Infuse IV admin over 10-60 min and at a rate of ≤30 mg/min. Single dose of IM inj should not exceed 600 mg nor is admin of above 1.2 g in a single 1 hour infusion.
  • Child: >1 month 15-25 mg/kg daily in 3 or 4 divided doses; in severe infections, increase to 40 mg/kg daily and a min dose of 300 mg daily should be given regardless of body wt.
Topical/Cutaneous-
Acne:
  • Adult: As 1% preparation: Apply a thin layer onto affected area bid.
Vaginal-
Bacterial vaginosis:
  • Adult: As pessary or 2% cream: 100 mg at bedtime for 3-7 days.

Administration

Clindamycin Lotion 1%: Clean the face or affected area gently with warm water or soap as recommended by the physician. After the skin is dried, apply a thin film of lotion to the affected areas twice daily, in the morning and in the evening.

Do not wash within three hours after using lotion. The treatment period is usually 6 weeks or as advised by the physician.

However, 8 to 12 weeks of treatment may be required for maximum benefit.

Clindamycin 2% Vaginal preparation: One applicator full (approximately 5 gm) intravaginally at bedtime for 7 consecutive days. In patients in whom a shorter treatment course is desirable, a 3 day regimen has been shown to be effective.

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 any of the ingredients of this medicine.

Side Effects

Abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.

Pregnancy & Lactation

Pregnancy Category B: Clindamycin crosses the placenta in humans. After multiple doses, amniotic fluid concentrations were approximately 30% of maternal concentrations. Clindamycin should be used in pregnancy only if clearly needed.

Lactation: Clindamycin has been reported to appear in breast milk. Therefore, it is not recommended for nursing mothers if not clearly needed.

Precautions

Clindamycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.

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 Conditions

Store between 20-25°C. Do not refrigerate or freeze.

Available Brand Names

  • Anobac Capsule
    150 mg
    Globe Pharmaceuticals Limited.
    Unit Price : ৳ 8.00
  • Anobac Capsule
    300 mg
    Globe Pharmaceuticals Limited.
    Unit Price : ৳ 15.00
  • Asiclin Capsule
    150 mg
    Asiatic Laboratories Ltd.
    Unit Price : ৳ 8.00
  • Asiclin IM/IV Injection
    150 mg/ml
    Asiatic Laboratories Ltd.
    2 ml ampoule : ৳ 39.00
  • Asiclin Capsule
    300 mg
    Asiatic Laboratories Ltd.
    Unit Price : ৳ 15.00
  • Cinamycin Capsule
    150 mg
    Ibn-Sina Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Cinamycin Capsule
    300 mg
    Ibn-Sina Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Cinamycin IM/IV Injection
    150 mg/ml
    Ibn-Sina Pharmaceuticals Ltd.
    2 ml ampoule : ৳ 40.00
  • Clen-X Capsule
    150 mg
    Virgo Pharmaceuticals Ltd.
    Price not available
  • Clen-X Capsule
    300 mg
    Virgo Pharmaceuticals Ltd.
    Price not available
  • Cleocin Vaginal Cream
    2%
    Healthcare Pharmacuticals Ltd.
    20 gm tube : ৳ 73.00
  • Cleocin Capsule
    150 mg
    Healthcare Pharmacuticals Ltd.
    Unit Price : ৳ 10.00
  • Cleocin Capsule
    300 mg
    Healthcare Pharmacuticals Ltd.
    Unit Price : ৳ 16.00
  • Cleodin Capsule
    150 mg
    General Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Cleodin Capsule
    300 mg
    General Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Cleodin IM/IV Injection
    150 mg/ml
    General Pharmaceuticals Ltd.
    2 ml ampoule : ৳ 40.00
  • Cleodin IM/IV Injection
    600 mg/4 ml
    General Pharmaceuticals Ltd.
    4 ml ampoule : ৳ 70.00
  • Cleomycin Capsule
    300 mg
    Rangs Pharmaceuticals Ltd.
    Price not available
  • Climax Capsule
    300 mg
    Ziska Pharmaceuticals Ltd.
    Price not available
  • Climax Capsule
    150 mg
    Ziska Pharmaceuticals Ltd.
    Price not available
  • Climax IM/IV Injection
    150 mg/ml
    Ziska Pharmaceuticals Ltd.
    2 ml ampoule : Price Unavailable
  • Climed Capsule
    150 mg
    Leon Pharmaceuticals Ltd.
    Unit Price : ৳ 8.02
  • Climed Capsule
    300 mg
    Leon Pharmaceuticals Ltd.
    Unit Price : ৳ 15.04
  • Climycin Capsule
    150 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 8.04
  • Climycin Capsule
    300 mg
    Square Pharmaceuticals Ltd.
    Unit Price : ৳ 15.05
  • Climycin IM/IV Injection
    150 mg/ml
    Square Pharmaceuticals Ltd.
    2 ml ampoule : ৳ 40.13
  • Clinabac Capsule
    300 mg
    The White Horse Pharma
    Price not available
  • Clinacyn Vaginal Cream
    2%
    Beximco Pharmaceuticals Ltd.
    Price not available
  • Clinacyn IM/IV Injection
    150 mg/ml
    Beximco Pharmaceuticals Ltd.
    2 ml ampoule : Price Unavailable
  • Clinacyn Capsule
    600 mg/4 ml
    Beximco Pharmaceuticals Ltd.
    Price not available
  • Clinacyn Lotion
    10 mg/ml
    Beximco Pharmaceuticals Ltd.
    Price not available
  • Clinacyn Capsule
    150 mg
    Beximco Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Clinacyn Capsule
    300 mg
    Beximco Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Clincin Capsule
    150 mg
    Navana Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Clincin Capsule
    300 mg
    Navana Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Clincin Powder for Suspension
    75 mg/5 ml
    Navana Pharmaceuticals Ltd.
    100 ml bottle : ৳ 250.75
  • Clindabac Capsule
    150 mg
    Popular Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Clindabac Capsule
    300 mg
    Popular Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Clindabac IM/IV Injection
    150 mg/ml
    Popular Pharmaceuticals Ltd.
    2 ml ampoule : ৳ 40.00
  • Clindabac IM/IV Injection
    600 mg/4 ml
    Popular Pharmaceuticals Ltd.
    4 ml ampoule : ৳ 70.00
  • Clindaben Capsule
    150 mg
    Benham Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Clindaben Capsule
    300 mg
    Benham Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Clindacap Capsule
    300 mg
    Astra Biopharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Clindacap Capsule
    150 mg
    Astra Biopharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Clindacin Vaginal Cream
    20 mg/gm
    Incepta Pharmaceuticals Limited
    20 gm tube : ৳ 70.00
  • Clindacin Capsule
    150 mg
    Incepta Pharmaceuticals Limited
    Unit Price : ৳ 8.00
  • Clindacin Capsule
    300 mg
    Incepta Pharmaceuticals Limited
    Unit Price : ৳ 15.00
  • Clindacin IM/IV Injection
    150 mg/ml
    Incepta Pharmaceuticals Limited
    4 ml ampoule : ৳ 70.00
  • Clindacin Powder for Suspension
    75 mg/5 ml
    Incepta Pharmaceuticals Limited
    Price not available
  • Clindacin Lotion
    10 mg/ml
    Incepta Pharmaceuticals Limited
    25 ml bottle : ৳ 125.00
  • Clindacin 300 IM/IV Injection
    300 mg/2 ml
    Incepta Pharmaceuticals Limited
    2 ml ampoule : ৳ 40.00
  • Clindamet Capsule
    150 mg
    Somatec Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Clindamet Capsule
    300 mg
    Somatec Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Clindaver Capsule
    300 mg
    Veritas Pharmaceuticals Ltd.
    Unit Price : ৳ 15.05
  • Clindax Vaginal Cream
    20 mg/gm
    Opsonin Pharma Ltd.
    20 gm tube : ৳ 61.80
  • Clindax Capsule
    150 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 7.06
  • Clindax Capsule
    300 mg
    Opsonin Pharma Ltd.
    Unit Price : ৳ 13.25
  • Clindax Oral Suspension
    75 mg/5 ml
    Opsonin Pharma Ltd.
    100 ml bottle : ৳ 220.75
  • Clindax IM/IV Injection
    150 mg/ml
    Opsonin Pharma Ltd.
    2 ml ampoule : ৳ 35.32
  • Clindax Lotion
    10 mg/ml
    Opsonin Pharma Ltd.
    25 ml bottle : ৳ 125.00
  • Clindax 600 IM/IV Injection
    600 mg/4 ml
    Opsonin Pharma Ltd.
    4 ml ampoule : ৳ 61.81
  • Clinex Capsule
    150 mg
    Aristopharma Ltd.
    Unit Price : ৳ 8.00
  • Clinex Capsule
    300 mg
    Aristopharma Ltd.
    Unit Price : ৳ 15.00
  • Clinex Lotion
    10 mg/ml
    Aristopharma Ltd.
    25 ml bottle : ৳ 125.00
  • Daclin Capsule
    150 mg
    ACI Limited.
    Unit Price : ৳ 8.00
  • Daclin Capsule
    300 mg
    ACI Limited.
    Unit Price : ৳ 15.00
  • Daclin Lotion
    10 mg/ml
    ACI Limited.
    25 ml bottle : ৳ 125.00
  • Dalacin Capsule
    300 mg
    Drug International Ltd.
    Unit Price : ৳ 15.00
  • Dalacin IM/IV Injection
    150 mg/ml
    Drug International Ltd.
    2 ml ampoule : ৳ 40.00
  • Dalacin IM/IV Injection
    600 mg/4 ml
    Drug International Ltd.
    4 ml ampoule : ৳ 70.00
  • Dalacin C Capsule
    300 mg
    Pfizer
    Unit Price : ৳ 53.01
  • Dalacin C IM/IV Injection
    150 mg/ml
    Pfizer
    4 ml ampoule : ৳ 332.03
  • Dalacin T Lotion
    10 mg/ml
    Pfizer
    Price not available
  • Endamycin Capsule
    150 mg
    Euro Pharma Ltd.
    Unit Price : ৳ 8.00
  • Endamycin Capsule
    300 mg
    Euro Pharma Ltd.
    Unit Price : ৳ 15.00
  • Fortior Capsule
    300 mg
    Pharmacil Limited
    Unit Price : ৳ 22.00
  • Linacin Capsule
    150 mg
    Sharif Pharmaceuticals Ltd.
    Unit Price : ৳ 8.00
  • Linacin Capsule
    300 mg
    Sharif Pharmaceuticals Ltd.
    Unit Price : ৳ 15.00
  • Lincocin Capsule
    150 mg
    Acme Laboratories Limited.
    Unit Price : ৳ 8.00
  • Lincocin Capsule
    300 mg
    Acme Laboratories Limited.
    Unit Price : ৳ 15.00
  • Lindamax Capsule
    150 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 8.00
  • Lindamax Capsule
    300 mg
    Eskayef Bangladesh Ltd.
    Unit Price : ৳ 15.00
  • Lindamax IM/IV Injection
    150 mg/ml
    Eskayef Bangladesh Ltd.
    2 ml ampoule : Price Unavailable
  • Lindamax Lotion
    10 mg/ml
    Eskayef Bangladesh Ltd.
    25 ml bottle : ৳ 125.00
  • Maxclin Capsule
    150 mg
    Alco Pharma Ltd.
    Unit Price : ৳ 8.00
  • Maxclin Capsule
    300 mg
    Alco Pharma Ltd.
    Unit Price : ৳ 15.00
  • Qcin Capsule
    150 mg
    Renata Limited
    Unit Price : ৳ 8.00
  • Qcin Capsule
    300 mg
    Renata Limited
    Unit Price : ৳ 15.00
  • Qcin IM/IV Injection
    150 mg/ml
    Renata Limited
    2 ml ampoule : ৳ 40.00
  • Qcin IM/IV Injection
    600 mg/4 ml
    Renata Limited
    4 ml ampoule : ৳ 70.00
  • Riboclin Capsule
    150 mg
    Biopharma Laboratories Ltd.
    Unit Price : ৳ 8.00
  • Riboclin Capsule
    300 mg
    Biopharma Laboratories Ltd.
    Unit Price : ৳ 15.00
  • Xindal Capsule
    150 mg
    Orion Pharma Ltd.
    Unit Price : ৳ 8.00
  • Xindal Capsule
    300 mg
    Orion Pharma Ltd.
    Unit Price : ৳ 15.00
  • Xioclin Capsule
    300 mg
    Edruc Ltd.
    Price not available