Cleocin (clindamycin) is a lincosamide antibiotic prescribed for the treatment of a wide range of serious anaerobic, streptococcal, and staphylococcal infections. It functions by inhibiting bacterial protein synthesis at the ribosomal level, effectively halting the growth and proliferation of susceptible organisms. This medication is available in several formulations, including oral capsules, topical solutions, and intravenous injections, allowing for tailored treatment approaches based on infection severity and location. It is a critical tool in the antimicrobial arsenal, particularly for patients with penicillin allergies or infections caused by resistant bacteria. Healthcare providers rely on its targeted spectrum and proven efficacy in both community and hospital settings.

Features

• Active pharmaceutical ingredient: Clindamycin phosphate or clindamycin hydrochloride
• Available formulations: Oral capsules (150 mg, 300 mg), topical gel/lotion/solution (1%), vaginal cream (2%), intravenous injection
• Mechanism of action: Binds to the 50S subunit of the bacterial ribosome, inhibiting protein synthesis
• Spectrum: Effective against aerobic gram-positive cocci and anaerobic bacteria
• Pharmacokinetics: Rapid absorption, high tissue penetration, hepatic metabolism, renal and biliary excretion

Benefits

• Provides potent bactericidal activity against a broad range of anaerobic pathogens
• Effective alternative for patients with hypersensitivity to beta-lactam antibiotics
• Demonstrates excellent tissue penetration, including bone and abscess fluids
• Available in multiple formulations allowing for flexible administration routes
• Established clinical efficacy in serious infections including intra-abdominal and pelvic infections
• Well-characterized safety profile with extensive clinical use history

Common use

Cleocin is commonly prescribed for serious infections caused by susceptible anaerobic bacteria, including Bacteroides fragilis, Fusobacterium, and Clostridium species. It is frequently used in the treatment of intra-abdominal infections, pelvic inflammatory disease, anaerobic pneumonias, and serious skin and soft tissue infections. Additionally, it serves as effective prophylaxis against bacterial endocarditis in penicillin-allergic patients undergoing dental procedures. Off-label uses include treatment of acne vulgaris (topical formulation) and malaria treatment in combination therapies (in specific geographic regions).

Dosage and direction

Oral administration: Adults: 150-450 mg every 6 hours; Children: 8-25 mg/kg/day divided into 3-4 doses
Intravenous administration: Adults: 600-2700 mg/day divided into 2-4 doses; Children: 20-40 mg/kg/day divided into 3-4 doses
Topical application: Apply thin layer to affected area twice daily
Vaginal cream: One applicatorful intravaginally at bedtime for 7 consecutive days

Dosage should be adjusted based on infection severity, pathogen susceptibility, and renal/hepatic function. Complete the full course of therapy even if symptoms improve earlier to prevent resistance development.

Precautions

Monitor patients for development of diarrhea throughout therapy and for several weeks following treatment completion. Use with caution in patients with gastrointestinal diseases, particularly colitis. Hepatic and renal function should be assessed periodically during extended therapy. May cause overgrowth of nonsusceptible organisms, including fungi. Topical application may cause contact dermatitis; avoid eye contact. Not recommended during pregnancy unless clearly needed (Category B). Clindamycin excretes in breast milk; consider risk-benefit ratio during lactation.

Contraindications

Hypersensitivity to clindamycin, lincomycin, or any component of the formulation. History of antibiotic-associated colitis, regional enteritis, or ulcerative colitis. Concomitant administration with erythromycin due to potential antagonism. Not for intrathecal administration. Topical formulations contraindicated in individuals with history of regional enteritis or ulcerative colitis.

Possible side effect

Common: Nausea, vomiting, diarrhea, abdominal pain, skin rash, pruritus
Serious: Clostridium difficile-associated diarrhea (may range from mild to life-threatening colitis), severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), hepatotoxicity, neutropenia, eosinophilia, thrombocytopenia, anaphylaxis, localized reactions at injection site
Topical: Dryness, peeling, itching, burning sensation, erythema, oiliness

Drug interaction

Increased effects/toxicity with: Neuromuscular blocking agents (enhanced blockade), erythromycin (antagonism)
Decreased effects with: Chloramphenicol (antagonistic activity)
Other interactions: Kaolin-pectin decreases absorption (separate administration by at least 2 hours), may affect cyclosporine levels (monitor accordingly)

Missed dose

Take the missed dose as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume regular dosing schedule. Do not double the dose to make up for the missed one. Maintain consistent timing between doses to ensure stable antibiotic levels.

Overdose

Symptoms may include severe gastrointestinal distress, bloody diarrhea, and neuromuscular blockade. No specific antidote exists. Management is supportive and symptomatic. Gastric lavage may be beneficial if administered shortly after ingestion. Hemodialysis is not effective for removal. Monitor for development of pseudomembranous colitis. Seek immediate medical attention for suspected overdose.

Storage

Store at controlled room temperature (20-25°C/68-77°F). Protect from light and moisture. Keep oral capsules in tightly closed containers. Do not freeze. Keep all medications out of reach of children and pets. Do not use beyond the expiration date printed on packaging. Properly discard any unused medication according to local regulations.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. The prescribing physician should make final determinations regarding appropriate therapy based on individual patient factors. Report any adverse reactions to the appropriate regulatory authority.

Reviews

“Cleocin remains a cornerstone in our surgical prophylaxis protocol, particularly for colorectal procedures. Its anaerobic coverage is exceptional, though we maintain vigilance for C. diff complications.” - Surgical Department, University Hospital

“Our dermatology practice has found the topical formulation particularly effective for inflammatory acne, with patients showing significant improvement in papule and pustule counts within 4-8 weeks.” - Dermatology Associates

“While an invaluable antibiotic, we’ve implemented strict antimicrobial stewardship protocols around clindamycin use due to rising C. difficile rates. Appropriate patient selection is crucial.” - Infectious Disease Committee