How long does it take clindamycin to work for bacterial infection?

The Clindamycin Fact Sheet

Clindamycin is an antibiotic in the lincosamide class, active against gram positive bacteria and anaerobes. It binds to the large subunit (50S) of the bacterial ribosome and inhibits new peptide-peptide bond formation. It is bacteriostatic in most cases, though can be bactericidal at high concentrations for certain species.

Because of its ability to inhibit translation, clindamycin at sub-inhibitory concentrations can reduce production of bacterial toxins in cases of streptococcal or staphylococcal toxic shock syndrome or in necrotizing infections. By contrast, beta-lactams can actually induce production of alpha toxin in S. aureus. Clindamycin can therefore work synergistically with bacterial cell-wall inhibiting agents such as penicillins, cephalosporins, and vancomycin for toxin-synthesizing gram positive species.

Clindamycin cannot penetrate Gram-negative organisms, so it is not active against them and does not affect Gram-negative endotoxin production.

Major Indications

The primary role for clindamycin is in skin and soft tissue infections. It is FDA-approved for use in SSTIs due to streptococcus or MSSA, toxic shock syndrome, impetigo, S. aureus osteomyelitis, pyomyositis, and amnionitis. It is also used off-label for anthrax, babesiosis, animal bite wounds (along with a cephalosporin), malaria treatment, MRSA infections, Pneumocystis pneumonia, septic arthritis, and MRSA SSTIs. For necrotizing SSTI, clindamycin can be given along with cefotaxime for polymicrobial infections, though vancomycin and pipercillin-tazobactam are recommended as first line, empiric treatment. If the necrotizing infection is known to be due to Clostridium perfringens or group A streptococcus, then clindamycin and penicillin IV are sufficient.

Clindamycin can also be used for other indications in patients who have severe penicillin allergies. These include treatment of group A streptococcal pharyngitis, pelvic inflammatory disease, and necrotizing skin infections. Topical clindamycin can be used for acne and intra-vaginally for treatment of bacterial vaginosis.

Notable History

Clindamycin has been available since 1968 after it was synthesized as a derivative of lincomycin, which is a natural product made by Streptomyces lincolnensis, an actinobacterium.

Recently In The News For

A 2015 NEJM article found no difference in treatment efficacy or in complication rates between clindamycin and trimethoprim-sulfamethoxazole for treatment of uncomplicated cellulitis and abscess. Using an intention-to-treat analysis, cure rates were 80.3% in the clindamycin group, and 77.7% in the TMP-SMX group (P=0.52). The study included both children and adults with a total of 524 patients, of whom 53.4% had cellulitis, 30.5% had an abscess, and 15.6% had a mixed infection. 41.4% of the cultures grew S. aureus, of which 77% were methicillin-resistant. However, the latest IDSA SSTI guidelines for treatment of mild abscesses recommend incision and drainage only, with no antibiotics.

Adverse Events

Common adverse reactions include nausea, vomiting, diarrhea, and abdominal pain. Anaphylactoid reactions and DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) can also occur.

Cautions

Clindamycin carries a black box warning for the risk of pseudomembranous colitis from C. difficile associated diarrhea (CDAD), which can be fatal. CDAD can occur during treatment with clindamycin, but has also been reported over 2 months after clindamycin use. It is important to take a good antibiotic history in the evaluation of patients with diarrhea to assess for CDAD risk. Because of the high risk of CDAD, other antibiotics should be considered before using clindamycin.

Dosing & Adjustments

Clindamycin is given IV at 600-900 mg Q8hr for severe infections. For mild infections, it can be given at 300-400 mg PO QID or 450 mg TID. Clindamycin has about 90% oral bioavailability, making it an attractive option for patients who do not have an IV, have limited IV access sites, and those who can be discharged on oral medications.

Special Considerations

Clindamycin is pregnancy class B, and is considered safe in breastfeeding women, as it is minimally excreted in the breast milk. Tell patients to take an 8-oz. glass of water with each clindamycin dose. That helps prevent esophagitis, which is a common adverse reaction if the pill is taken with only a small sip of water.

Cost

A single dose of 600mg IV clindamycin costs from $3-$15. An oral clindamycin course of 300mg QID for 10 days costs around $150. The 1% topical clindamycin costs $50-$80 for a 30-g tube, while vaginal 2% clindamycin costs over $100 for a 40-g tube.

Christina Shenvi, MD, PhD, is an assistant professor in the department of emergency medicine at the University of North Carolina. She authors RX Pad each month in EPM. A version of this article originally appeared at Emergency Physicians Monthly.

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Clindamycin

Generic Name: clindamycin (oral/injection) (klin da MYE sin)
Brand Names: Cleocin HCl, Cleocin Pediatric, Cleocin Phosphate, Cleocin Phosphate ADD-Vantage, Clindesse, ClindaMax Vaginal

Medically reviewed by Kaci Durbin, MD Last updated on Aug 1, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Tips
  • Interactions
  • More

What is clindamycin?

Clindamycin is an antibiotic that fights bacteria in the body.

Clindamycin is used to treat serious infections caused by bacteria.

Clindamycin may also be used for purposes not listed in this medication guide.

Important information

Clindamycin can cause diarrhea, which may be severe or lead to serious, life-threatening intestinal problems. If you have diarrhea that is watery or bloody, stop using this medicine and call your doctor.

Before using clindamycin, tell your doctor if you have kidney disease, liver disease, an intestinal disorder such as colitis or Crohn’s disease, or a history of asthma, eczema, or allergic skin reaction.

Take clindamycin for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Clindamycin will not treat a viral infection such as the common cold or flu.

Before taking this medicine

You should not use this medicine if you are allergic to clindamycin or lincomycin.

To make sure clindamycin is safe for you, tell your doctor if you have ever had:

  • colitis, Crohn’s disease, or other intestinal disorder;

  • eczema, or allergic skin reaction;

  • liver disease;

  • asthma or a severe allergic reaction to aspirin;

  • an allergy to yellow food dye.

Animal studies have not shown any harm during pregnancy, but in humans, it is not known whether clindamycin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Clindamycin does pass into breast milk and may cause side effects in the nursing baby. If you are breastfeeding while taking this medicine, call your doctor if your baby has diaper rash, redness or white patches in the mouth or throat, stomach discomfort, or diarrhea that is watery or bloody. Let your doctor know if you are breastfeeding before taking clindamycin.

Clindamycin injection may contain an ingredient that can cause serious side effects or death in very young or premature babies. Do not give this medicine to a child without medical advice.

How should I use clindamycin?

Take clindamycin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Clindamycin oral is taken by mouth. Clindamycin injection is injected into a muscle, or as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Take the capsule with a full glass of water to keep it from irritating your throat.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You may need frequent medical tests during treatment.

If you need surgery, let your surgeon know you use clindamycin as it may interact with certain drugs used for anesthesia.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Clindamycin will not treat a viral infection such as the flu or a common cold.

Store at room temperature away from moisture and heat. Protect the injectable medicine from high heat.

Do not store the oral liquid in the refrigerator. Throw away any unused oral liquid after 2 weeks.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using clindamycin?

Do not use clindamycin at the same time as the antibiotic, erythromycin.

Clindamycin side effects

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop using clindamycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Get emergency medical help if you have any signs of an allergic reaction to clindamycin: (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Seek medical treatment if you have symptoms of a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using clindamycin.

Clindamycin can cause diarrhea, which may be severe or lead to serious, life-threatening intestinal problems. If you have diarrhea that is watery or bloody, stop using clindamycin and call your doctor.

Call your doctor at once if you have:

  • any change in bowel habits;

  • severe stomach pain, diarrhea that is watery or bloody;

  • little or no urination; or

  • a metallic taste in your mouth (after clindamycin injection).

Common clindamycin side effects may include:

  • nausea, vomiting, stomach pain;

  • mild skin rash; or

  • vaginal itching or discharge;

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect clindamycin?

Other drugs may interact with clindamycin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 12.01.

Related questions

  • Can clindamycin be used to treat chlamydia?

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More about clindamycin

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Consumer resources

  • Clindamycin Capsules
  • Clindamycin Injection
  • Clindamycin Oral Solution
  • Clindamycin (Advanced Reading)
  • Clindamycin Oral, Injection, Intravenous (Advanced Reading)

Other brands: Cleocin, Cleocin Pediatric, Cleocin Phosphate, Cleocin HCl

Professional resources

  • Clindamycin Hydrochloride (AHFS Monograph)
  • … +7 more

Related treatment guides

  • Aspiration Pneumonia
  • Bacteremia
  • Babesiosis
  • Bacterial Endocarditis Prevention
  • … +19 more

0 shares 1 min

Clindamycin is a powerful antibiotic usually reserved for very serious bacterial infections – of the lungs, skin, blood, female reproductive organs and other internal organs. It carries an FDA black-box warning to alert doctors and patients about possible adverse effects, including swelling of the face and tongue and serious skin reactions.

Clindamycin may be given to patients who can’t take penicillin because they’ve had an allergic reaction to it. This antibiotic wouldn’t be a first choice for a urinary tract infection, but you don’t say whether your wife’s infection failed to respond to other treatment before the Clindamycin was prescribed. (I would hope that her physician had a good reason for choosing it.) One reason that Clindamycin should be used with care is that it disrupts normal flora in the intestinal tract, sometimes causing a severe (rarely fatal) intestinal condition called pseudomembranous colitis. This can occur during treatment or up to two months later. The symptoms to watch out for are abdominal pain, nausea, vomiting, and diarrhea. If any occur during or following treatment, be sure to contact your physician immediately.

Nearly all antibiotics can cause the same intestinal problems as Clindamycin. For that reason, it is important to take a probiotic supplement throughout antibiotic treatment and for at least 10 days following.

Because of the anatomy of the female urethra, women are very susceptible to urinary tract infections. To help prevent them, I recommend practicing prudent and practical hygiene (such as wiping front to back and urinating after intercourse), as well as drinking unsweetened cranberry juice concentrate diluted with water or taking powdered cranberry extract in capsules. Cranberries contain a substance that helps prevent certain types of bacteria from sticking to the bladder wall. Drink lots of water in order to urinate more frequently and avoid alcohol and coffee, which are bladder irritants.

Andrew Weil, M.D.

Source:
Clindamycin, Medline Plus, National Institutes of Health, May 7, 2019, medlineplus.gov/druginfo/meds/a682399.html

Here is more information about the prevention and treatment of urinary tract infections.

Clindamycin Hydrochloride Capsules

Metabolism And Excretion

Extensive studies of the metabolism and excretion of clindamycin hydrochloride administered orally in animals and humans have shown that unchanged drug and bioactive and bioinactive metabolites are excreted in urine and feces. Almost all of the bioactivity detected in serum after clindamycin hydrochloride product administration is due to the parent molecule (clindamycin). Urine bioactivity, however, reflects a mixture of clindamycin and active metabolites, especially N-dimethyl clindamycin and clindamycin sulfoxide.

Animal Safety Summary

One year oral toxicity studies in rats and dogs at doses of 30, 100 and 300 mg/kg/day (13.6, 45.5 and 136.4 mg/lb/day) have shown clindamycin hydrochloride capsules to be well tolerated. Differences did not occur in the parameters evaluated to assess toxicity when comparing groups of treated animals with contemporary controls. Rats administered clindamycin hydrochloride at 600 mg/kg/day (272.7 mg/lb/day) for six months tolerated the drug well; however, dogs orally dosed at 600 mg/kg/day (272.7 mg/lb/day) vomited, had anorexia, and subsequently lost weight. At necropsy these dogs had erosive gastritis and focal areas of necrosis of the mucosa of the gall bladder.

Safety in gestating bitches or breeding males has not been established.

dogs: Skin Infections (wounds And Abscesses) due To Coagulase Positive Staphylococci (staphylococcus Aureus Or staphylococcus Intermedius). deep Wounds And Abscesses due To bacteroides Fragilis, Prevotella Melaninogenicus, Fusobacterium Necrophorum And clostridium Perfringens. dental Infections due To staphylococcus Aureus, Bacteroides Fragilis, Prevotella Melaninogenicus, Fusobacterium Necrophorum And clostridium Perfringens. osteomyelitis due To staphylococcus Aureus, Bacteroides Fragilis, Prevotella Melaninogenicus, Fusobacterium Necrophorum And clostridium Perfringens.

contraindications

Clindamycin Hydrochloride Capsules are contraindicated in animals with a history of hypersensitivity to preparations containing clindamycin or lincomycin.

Because of potential adverse gastrointestinal effects, do not administer to rabbits, hamsters, guinea pigs, horses, chinchillas or ruminating animals.

Warnings

Keep out of reach of children. Not for human use.

Precautions

During prolonged therapy of one month or greater, periodic liver and kidney function tests and blood counts should be performed. The use of clindamycin hydrochloride occasionally results in overgrowth of non-susceptible organisms such as clostridia and yeasts. Therefore, the administration of Clindamycin Hydrochloride Capsules should be avoided in those species sensitive to the gastrointestinal effects of clindamycin (see CONTRAINDICATIONS). Should superinfections occur, appropriate measures should be taken as indicated by the clinical situation. Patients with very severe renal disease and/or very severe hepatic disease accompanied by severe metabolic aberrations should be dosed with caution, and serum clindamycin levels monitored during high-dose therapy.

Clindamycin hydrochloride has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents. Therefore, Clindamycin Hydrochloride Capsules should be used with caution in animals receiving such agents.

Safety in gestating bitches or breeding male dogs has not been established.

Adverse Reactions

Side effects occasionally observed in either clinical trials or during clinical use were vomiting and diarrhea.

Clindamycin Hydrochloride Capsules Dosage And Administration

2.5-15.0 mg/lb body weight every 12 hours.

Duration

Treatment with Clindamycin Hydrochloride products may be continued up to a maximum of 28 days if clinical judgment indicates. Treatment of acute infections should not be continued for more than three or four days if no response to therapy is seen.

Dosage Schedule

Clindamycin Hydrochloride 25 mg, administer 1-6 capsules every 12 hours for each 10 pounds of body weight.

Clindamycin Hydrochloride 75 mg, administer 1-6 capsules every 12 hours for each 30 pounds of body weight.

Clindamycin Hydrochloride 150 mg, administer 1-6 capsules every 12 hours for each 60 pounds of body weight.

Clindamycin Hydrochloride 300 mg, administer 1-6 capsules every 12 hours for each 120 pounds of body weight.

Dogs: Osteomyelitis

5.0-15.0 mg/lb body weight every 12 hours. Treatment with Clindamycin Hydrochloride is recommended for a minimum of 28 days. Treatment should not be continued for longer than 28 days if no response to therapy is seen.

How Supplied

Clindamycin Hydrochloride Capsules are available as:

25 mg capsules supplied in bottles of 600

75 mg capsules supplied in bottles of 200

150 mg capsules supplied in bottles of 100

300 mg capsules supplied in bottles of 100

Store At Controlled Room Temperature 20°-25°c (68°-77°f).

To report a suspected adverse reaction or to request a material safety data sheet (MSDS), call 1-800-759-3664.

Clindamycin Hydrochloride Capsules Caution

Federal law restricts this drug to use by or on the order of a licensed veterinarian.

Keep Container Tightly Closed.

Manufactured by IVX Animal Health, Inc., St. Joseph, MO 64503

Manufactured For: Clipper Distributing Company, Llc, St. Joseph, Mo 64507

Trademarks are property of Clipper Distributing Company, LLC.

Net Contents:

NDC

25 mg

600 Capsules

801022 Rev. 2-04

75 mg

200 Capsules

801023 Rev0506

150 mg

100 Capsules

801024 Rev0706

300 mg

100 Capsules

801037 Rev0607

Clindamycin Prescription Online

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Clindamycin (Cleocin) – Summary

Clindamycin, marketed under the name Cleocin, is an antibacterial drug used in the treatment of a wide range of infections. Push Health connects people who might need to use prescription clindamycin with a medical provider who can prescribe Cleocin if it is safe and appropriate to do so.

What Is Clindamycin Used For?

Clindamycin (Cleocin) is a derivative of the compound lincomycin. Clindamycin is a semisynthetic antibiotic that is used to treat infections that are proven or strongly suspected to be caused by bacteria susceptible to clindamycin. Clindamycin’s mechanism of action involves binding to the 50s subunit of the bacterial ribosome and blocking the synthesis of bacterial proteins. Clindamycin is considered a bacteriostatic drug and has activity against some Gram-positive aerobes, Gram-positive anaerobes and Gram-negative anaerobes.

Clindamycin – Dosage

Cleocin HCl contains clindamycin hydrochloride (clindamycin HCl), a hydrated hydrochloride sale version of clindamycin. Cleocin HCl capsules contain clindamycin HCl 75 mg, clindamycin HCl 150 mg, or clindamycin HCl 300 mg in addition to some inactive ingredients. Cleocin (clindamycin) capsules range in color from blue to green and should be stored at 20° C to 25° C. Clindamycin hydrochloride is absorbed quickly after being administered orally, reaching its peak level in under 60 minutes, whether or not food was administered at the same time. Clindamycin is distributed widely in body fluids and has an average half-life of 2.4 hours which is slightly increased in people with impaired kidney function. Clindamycin is excreted in both the urine and the feces. Clindamycin is moderately affordable at under 50 cents per capsule at most pharmacies. Cleocin (clindamycin) coupons are available online to help reduce the cost of the medication if insurance does not cover it.

Clindamycin Gel / Cream / Lotion

Many people have heard of clindamycin gel, clindamycin cream and clindamycin lotion forms. But is clindamycin for acne in the form of a gel or lotion still used? Clindamycin phosphate topical gel 1% has been approved for the treatment of acne vulgaris and was found to help reduce lesion counts by the end of treatment. Clindamycin is combined with benzoyl peroxide in some gel treatments as well.

Can I Buy Clindamycin (Cleocin) Online?

Clindamycin (Cleocin) is a prescription medication in the US and is not available over-the-counter. Also, legally, one cannot buy clindamycin online unless one has a prescription and works with a licensed pharmacy. People who are in need of a clindamycin prescription, however, can connect with a medical provider through Push Health who can prescribe Cleocin or clindamycin if clinically appropriate to do so.

Clindamycin – Side Effects

Clindamycin can cause side effects, including nausea, vomiting, diarrhea, abdominal pain, itching and a rash. Clindamycin (Cleocin HCl) is contraindicated in individuals with a known hypersensitivity or allergy to clindamycin or lincomycin. Clindamycin use can result in Clostridium difficile associated diarrhea and people with a history of gastrointestinal disease should generally not use clindamycin. Clindamycin (Cleocin) and alcohol should not be used together. A good place to direct questions and concerns about side effects related to clindamycin use is one’s medical provider and pharmacist.

More Clindamycin Information

Last updated May 15, 2019. Given the evolving nature of medicine and science, this information might not be accurate and should not be construed as medical advice or diagnosis / treatment recommendations. Please consult a licensed medical provider if you have additional questions.

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