Clindamycin

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Pharmacology

Summary

Clindamycin is an antibiotic that functions similar to a macrolide, in that it inhibits bacterial protein synthesis through binding to the 50S ribosomal subunit, thereby halting bacterial growth.

This antibiotic demonstrates activity against gram-positive organisms, such as Streptococci, Staphylococci, and Bacteroides fragilis, and also gives coverage against Methicillin-resistant Staphylococcus aureus (MRSA). It also has activity against anaerobic bacteria and can penetrate abscesses, and thus is useful for lung abscesses caused by anaerobes. It's also effective in handling oral infections caused by anaerobes like Fusobacterium, Bacteroides, and Clostridium (e.g. Clostridium perfringens). Apart from these, it addresses skin problems like inflammatory acne caused by skin anaerobes, and genital tract infections like bacterial vaginosis caused by Gardnerella.

Adverse effects of clindamycin include gastrointestinal symptoms such as nausea, vomiting, and diarrhea. A severe complication, Clostridioides difficile-associated diarrhea (CDAD), can also arise, and warrants prompt intervention.

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FAQs

What is the mechanism of action of clindamycin?

Clindamycin acts on the bacterial 50S ribosomal subunit, which inhibits translocation during protein synthesis. This bacteriostatic action interferes with the ability of bacteria to grow and replicate.

What infections can clindamycin be used to treat?

Clindamycin has broad activity and can be used to treat a variety of infections including Staphylococcal and Streptococcal infections, cellulitis caused by Strep pyogenes, MRSA infections, aerobic and anaerobic oral infections, lung abscesses, and aspiration pneumonia. Topically, it's used to treat moderate to severe inflammatory acne vulgaris. Moreover, clindamycin can treat infections caused by Clostridium perfringens, such as gangrene, and bacterial vaginosis caused by Gardnerella vaginalis. In combination with gentamicin, it's often used to treat polymicrobial female genital tract infections like endometritis.

Is clindamycin effective against MRSA?

Yes, clindamycin is a treatment option for methicillin-resistant Staphylococcus aureus (MRSA) infections, including skin and soft tissue infections.

What are some potential side effects of clindamycin?

One of the common side effects of clindamycin includes diarrhea. More serious side effects can be associated with pseudomembranous colitis caused by Clostridium difficile, which can occur from antibiotic use and can range from mild to severe symptoms.

Why might gentamicin be paired with clindamycin for treatment?

Gentamicin, an aminoglycoside, is often paired with clindamycin to provide broad coverage against both gram-negative and gram-positive organisms. This combination is particularly useful in treating infections like endometritis where multiple types of bacteria may be present.