Clindamycin

Lincosamide antibiotic, Antibacterial

Clindamycin

Cleocin (oral, IV); Clindesse, Cleocin (vaginal); Clindets, Cleocin T (topical)

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Pharmacy

Starting dose

Oral 300-450 mg PO QID; IV 600-900 mg q8h; topical 1% solution/gel BID; vaginal 100 mg ovule × 3 days or 2% cream × 7 days

Preparations

75, 150, 300 mg capsules; 75 mg/5 mL solution; 150 mg/mL IV; 1% topical; 2% vaginal cream

US FDA Max

4.8 g/d (IV severe infection)

Common uses

Classification(s)

Classes

Lincosamide antibiotic, Antibacterial

Pharmacology

Routes

Oral, IV, IM, topical, vaginal

Onset

Hours

Duration

6-8 hours

Half-life

~2.5-3 hours

Bioavailability

~90% (oral)

Pregnancy

Generally considered safe.^{[citation needed]}

Legal status

Rx-only in US. Carries a Boxed Warning for Clostridioides difficile colitis (one of the most C. difficile-inducing antibiotic classes)

Purported mechanism

Clindamycin reversibly binds the 23S rRNA of the bacterial 50S ribosomal subunit at a site overlapping the macrolide binding site, blocking peptide bond formation and inhibiting protein synthesis; the result is bacteriostatic against most organisms and bactericidal at high concentrations against susceptible strains.▲0▼ Active against gram-positives (Staph including some MRSA, streptococci including viridans), anaerobes (Bacteroides, Clostridia other than difficile, Peptostreptococcus), and Toxoplasma. Inducible MLSb resistance (D-test required for staph) and rising community MRSA resistance limit empiric reliability. Strong association with C. difficile colitis is the clinical-use ceiling.