Clindamycin

With the active ingredient Clindamycin it is an antibiotic that belongs to the pharmacological category of lincosamides. Clindamycin is a so-called semi-synthetic derivative of the substance lincomycin.

What is clindamycin?

Clindamycin belongs to the subgroup of lincosamide antibiotics. The active ingredient is obtained from lincomycin and is then in chlorinated form. The substance is produced in a semi-synthetic way. In the usual doses, the drug clindamycin, as a rule, shows a bacteriostatic effect. In higher doses, however, the drug has a bactericidal effect, i.e. it kills bacteria.

The active ingredient clindamycin is primarily effective against gram-positive aerobic pathogens. These include, for example, staphylococci or streptococci. In addition, the substance clindamycin also has an anti-anaerobic effect, especially against gram-negative germs and chlamydia.If the substance clindamycin is used together with the substance pyrimethamine, the compound is also effective against Toxoplasma gondii.

Pharmacological effect

The substance clindamycin inhibits the synthesis of proteins in bacteria. The substance has a similar effect to the macrolides, which bind to a certain subunit of the ribosomes. Because the mechanism of action is the same, cross-resistance occurs in some cases.

When the drug clindamycin is administered orally, approximately 90 percent of the active ingredient is absorbed. At the same time there is a binding to plasma proteins of 92 to 94 percent. Basically, the plasma half-life of the substance clindamycin is around 2.4 hours. The substance reaches the internal organs as well as the bone marrow, the pleural fluid, the skin and breast milk. In addition, the drug is able to penetrate the placental barrier. The active substance is remodeled in the liver. Eventually, the drug clindamycin is excreted in the urine and stool.

By inhibiting the bacterial synthesis of proteins, an enzyme called peptidyl transferase is stopped. The spectrum of action of the drug clindamycin is relatively broad. For example, it works against gram-positive cocci such as Streptococcus pyogenes or pneumoniae. With regard to anaerobes, for example, the drug works against Actinomyces, Peptostreptococcus, Fusobacterium and Bacteroides.

The antibiotic clindamycin, on the other hand, shows little or no effect on aerobic gram-negative rod-shaped bacteria, enterococci, species of Haemophilus or Neisseria.

In principle, it is possible that taking the drug clindamycin also creates secondary resistance to antibiotics as certain structures on the ribosomes change. Meals hardly affect the absorption of the active substance while taking the drug.

The substance clindamycin is tissue-permeable and accumulates in the bones. The active substance is heavily metabolized in the liver. About a third of the amount of active ingredient ingested is excreted unchanged via the kidneys.

Medical application & use

The drug clindamycin is used for a wide variety of infections. Clindamycin is often used in particular in the context of the therapy of abscessing inflammation of the lungs, chronic osteomyelitis, osteomyelitis in a diabetic foot or infections in the oral cavity.

The drug is also used for infections of joints and bones or the female genital organs. Clindamycin can also be used to treat acne vulgaris.

The possible areas of application are similar to those of other well-tolerated macrolides. Infections caused by staphylococci are an exception. Because against these macrolides usually show no effect. In addition, clindamycin is also used as a substitute preparation for patients who suffer from an allergy to penicillin.

In veterinary medicine, clindamycin is also used for serious infections of the skin, eyes or respiratory tract. Basically, clindamycin is a reserve antibiotic, so it is not always used as the first choice for possible indications.

As a rule, the active ingredient clindamycin is taken orally, depending on the indication. Both tablets and capsules are available. In addition, parenteral administration of the active ingredient as an infusion solution or local application using gels or ointments is possible.

Risks & side effects

As part of therapy with the drug clindamycin, a number of undesirable side effects are possible, which vary depending on the individual case. Primarily gastrointestinal complaints such as diarrhea, vomiting or cramps in the epigastric region occur due to the drug.

In addition, pseudomembranous colon inflammation is possible, which in some cases forms as a result of antibiotic use. This creates complications that are more common with clindamycin than with other types of antibiotics. In such a case, treatment with the active substance must be stopped immediately. Rare side effects of the drug include itching, sores on the skin, and vaginal catarrh.

Clindamycin is not indicated during breastfeeding, as the active ingredient passes into breast milk. Other potential side effects include damage to the liver, which is associated with an increased concentration of transaminases. At the same time, the risk of allergies and leukocytopenia increases.

In principle, the drug clindamycin must not be taken if the patient is allergic to lincosamide antibiotics. If side effects or other complaints occur, a doctor should be consulted immediately.