Clindamycin Flashcards
CLINDAMYCIN:
What are common indications of clindamycin?
Acne vulgaris
BV
Moderate to severe- cellulitis, osteomyelitis, septic arthritis, and intraabdominal infection
2nd/3rd line w/ other Abx
Plasmodium falciparum malaria w/ quinine
CLINDAMYCIN:
What is their spectrum of activity?
Gram positive aerobes(staph/ strep)
Anearobes- BV/ intraabdominal sepsis
CLINDAMYCIN:
What is mechanism of action?
Binds to ribosomes and inhibits the early stages of bacterial protein synthesis.
bacteriostatic- facilitating clearance of microorganism
CLINDAMYCIN:
How do bacteria resist the actions of clindamycin?
by modifying target proteins, reducing binding affinity.
CLINDAMYCIN:
what are common side effects?
Generally well tolerated
diarrhoea- (confirm not c.diff)
abdominal pain
skin rash
abnormal liver enzyme levels
Antibiotic associated colitis
Rare but severe;
-blood dyscrasias
-stevens-johnsons syndrome
-drug reaction with eosinphillia and systemic symptoms
What are cautions and contraindications of clindamycin?
IBS -caution
acute porphyria- avoided (unless needed for serious or life threatening)
why are suitable options in clindamycin allergy and why?
Penicillins as there is no cross sensitivy with it and clindamycin
CLINDAMYCIN:
What are dosages for acne and BV?
Acne:
topical clindamycin 1-2% should be applied thinly one to two times daily
BV:
5g of 2% cream intravaginally every night.
Why must clindaymycin be diluted in 5% glucose or 0.9% NaCl infused over 10-60 minutes?
Rare reports of cardiorespiratory arrest with rapid IV administration .
What advice would you give to patients treated for BV?
Sexual intercourse and vaginal products are not recommended
Clindamycin cream may weaken condoms and diaphragm.
How would you monitor efficacy?
Improvement of symptoms
Inflammatory markers-CRP, white cell count
How would you monitor for safety?
Bowel habits
liver enzymes
renal function in those requiring systemic treatment>10 days
Set a stop/review date for abx, referring to local protocols for guidance
Ensure a balance of effective treatment and reducing adverse reactions.
How long is the treatment for acne?
6 months, stopped soon after this is possible.
When is long-term systemic treatment needed?
For deep seated infection, e.g osteomyelitis
Why is clindamycin is reserved for serious infections?
Due to risk of side effects, especially C.diff.
Limiting its use also reduces emergence of resistance. Preserving its efficacy.
