Review of clindamycin capsules Side effects and uses

In recent years, we have seen extensive efforts to improve and develop new drugs with the aim of improving efficiency and reducing side effects in the treatment of various diseases. Clindamycin is an antibiotic from the macrolide family that is used in the treatment of various bacterial infections. This drug is known as a powerful tool in the fight against various infections due to a wide range of antibacterial activity and special features such as variable absorption from the digestive system and density of pathogenic tissues. In the rest of the article, we will examine the medicinal forms, uses and contraindications of this medicine.

Dosage forms of clindamycin

Chemical and herbal medicines available in the market are produced in different forms depending on the needs of patients and doctors. Clindamycin medicine in different forms including 75, 150 and 300 mg capsules, 150 mg/ml injectable solution, 75 mg/5 ml oral solution or syrup, 300 mg/50 ml ready-to-use intravenous solution (dextrose) 5%), 600 mg/50 ml (5% dextrose) and 900 mg/50 ml (5% dextrose) are available in pharmacies. Among these pharmaceutical forms, the capsule of this medicine is widely used in Iran.

Uses of clindamycin capsules

This drug is used to treat a wide range of bacterial infections, in fact, this antibiotic works by stopping the growth of bacteria. This product does not work for viral infections (such as colds, flu). Using any antibiotic when it is not needed can make it ineffective for subsequent infections. This medicine should not be used to treat meningitis. As a result, clindamycin capsules are used to treat infections, serious infections caused by anaerobic bacteria, amnionitis, inhalation and digestive anthrax (off-label), bacterial vaginosis, etc.

Uses of clindamycin capsules in adults

1. Treatment of infection
2. Serious infections caused by anaerobic bacteria
3. amnionitis
4. Inhalation and gastrointestinal anthrax (off label)
5. Bacterial vaginosis
6. Pelvic inflammatory disease
7. Toxic shock syndrome
8. Prevention of endocarditis (off label)
9. CNS toxoplasmosis, with pyrimethamine or leucovorin (off label)
10. Gardnerella Vaginalis (off label)
11. Pneumocystis (Carinii) Jiroveci (off label)
12. sarcoidosis (orphan)

Uses of clindamycin capsules in children

1. Treatment of infections
2. Serious infections caused by anaerobic bacteria
3. anthrax
4. Streptococcal pharyngitis
5. Endocarditis
6. Mouth and face infections

Pharmacological effects and mechanism of action of clindamycin capsules

The mechanism of action of clindamycin suppresses protein synthesis by binding to 50S ribosomal subunits. Bacteriostatic or bactericidal depending on the concentration of the drug, the organism and the site of infection. Absorption of this drug is with rapid bioavailability of 90% and maximum serum time in 60 minutes (PO). The drug is widely distributed in urine and bone, and there are no significant levels in CSF, even with inflamed meninges.

Dosage of clindamycin capsules

The amount and time of taking this capsule are different for different diseases. For this reason, the time and amount of general use for this drug should be considered separately. This drug is usually prescribed 2 to 4 times a day by injection into a vein or muscle. Dosage is based on your medical condition and response to treatment. The dose used in children is determined based on their weight depending on the condition of the disease and infection. In the following, we will examine the amount and time of clindamycin capsule consumption in different diseases.

Dosage of clindamycin capsules in the treatment of infection

1. Use 600-1200 mg/day of this product in the presence of aerobic gram-positive cocci and more sensitive anaerobes (generally including Bacteroides fragilis, Peptococcus species, and Clostridium species other than Clostridium perfringens).
2. More severe infections, especially those caused by suspected or proven bacteria, Peptococcus species, or Clostridium species other than Clostridium perfringens, should be prescribed 1,200 to 2,700 mg/day.
3. For more serious infections, these doses may be increased. In life-threatening situations due to aerobic or anaerobic conditions, these doses may be increased. For this reason, doses of 4800 mg per day are prescribed for adults.
4. A single intramuscular injection of more than 600 mg is not recommended.

The dosage of clindamycin capsules in the treatment of anaerobic bacteria infection

1. The dosage of this drug for the treatment of infections caused by anaerobic bacteria should be 150-450 mg every 6-8 hours, which should not exceed 1.2 grams per day.
2. Another dose of 2-2.7 grams per day is prescribed between 6 and 12 hours, which should not exceed 4.8 grams per day.

Dosage of clindamycin capsules for inhalation and gastrointestinal anthrax

1. To treat amnionitis, 450-900 mg should be taken every 8 hours.
2. For the treatment of inhalation and digestive anthrax, 900 mg every 8 hours or with ciprofloxacin 400 mg every 12 hours or doxycycline 300-150 mg every 12 hours is prescribed.

Dosage in other cases of using this medicine

1. For the treatment of bacterial vaginosis, 300 mg for 7 days
2. For surgical prophylaxis, 900 mg one hour before surgery
3. Bite wound (human or animal) 300 mg every 6 hours
4. Gangrenous pyomyositis every 8 hours with penicillin G
5. Group B streptococcus prophylaxis for newborns 900 mg every 8 hours until delivery
6. Oral and facial infections 450-150 mg every 6 hours for 7 days
7. CNS toxoplasmosis, with pyrimethamine or leucovorin 600 mg for at least 6 weeks
8. Prevention of endocarditis 600 mg 30-60 minutes before surgery

Time to take clindamycin capsules

Antibiotics work best when the amount of medicine in your body is kept at a constant level. Use this medicine at equal intervals. Continue taking this medicine even until your illness is cured and until the prescribed amount is completely finished. Stopping the medication early may allow the bacteria to continue to grow, which may lead to a return of the infection. The exact time and dosage of clindamycin is fully explained to you in the above section.

Precautions

Before using this medicine, tell your doctor about your medical history. Some of these history include kidney disease, liver disease, stomach or intestinal disease (such as colitis), clindamycin may cause live bacterial vaccines (such as typhoid vaccine). Before doing any immunization or vaccination, etc. If you are pregnant, tell your doctor before using this medicine because this medicine passes into breast milk. Some cautions for clindamycin are listed below.

1. If you forget a dose of medicine, take it as soon as you remember. Never take a double dose to make up for a missed dose.
2. The dosage and amount of this medicine is very different for different diseases. Patients should strictly refrain from taking this medicine on their own and seek advice from their doctor if necessary.
3. Arbitrary and indiscriminate use of these drugs can cause microbial resistance.
4. In case of complete disappearance of the disease, take your medicine prescription completely so that the bacteria is completely eradicated.

Clindamycin contraindications

1. Clostridium difficile-associated diarrhea (CDAD) has been reported and may range in severity from mild diarrhea to fatal colitis.
2. C difficile produces toxins A and B that contribute to CDAD. Hypertoxin-producing C difficile strains increase morbidity and mortality (may be resistant to antimicrobial therapy and may require colectomy).
3. If CDAD (fungal infection) is suspected or confirmed, continuous antibiotic use that has not been directed against C. difficile may require discontinuation of the drug.

Side effects of clindamycin capsules

In some patients, after taking this medicine, side effects of nausea, vomiting, unpleasant taste in the mouth (if this medicine is injected into a vein), or pain at the injection site (if this medicine is injected into a muscle) have been observed. If any of these effects last or get worse, tell your doctor or pharmacist right away. Remember that this medication has been prescribed because your doctor has determined that the benefits to you are greater than the risk of side effects. Some of the side effects of clindamycin include the following.

• Abdominal pain and diarrhea
• Agranulocytosis
• Eosinophilia (transient)
• Overgrowth of fungus
• Pseudomembranous colitis
• Hypersensitivity
• Stevens-Johnson syndrome
• Rashes and hives
• high blood pressure
• Nausea and vomiting
• Sterile abscess at IM site
• Thrombophlebitis
• Granulocytopenia
• Thrombocytopenia
• polyarthritis
• Kidney dysfunction

Drug interaction of clindamycin capsules

Make a list of the medicines you use during the day and show it to the doctor when you see him. Drug interactions may change how your medications work or increase your risk of serious side effects. Do not start, stop, or change the dosage of any medication without your doctor’s approval. Some of these drugs, including neuromuscular blocking drugs, neostigmine, pyridostigmine, erythromycin, chloramphenicol, etc., can cause drug interactions with clindamycin.

Use of clindamycin (clindamycin) during pregnancy and breastfeeding

In clinical trials with pregnant women, the systemic administration of clindamycin in the second and third trimesters of pregnancy was not associated with an increase in the frequency of congenital anomalies. This medicine should be used in the first trimester of pregnancy only if necessary. No adequate and well-controlled studies have been conducted in pregnant women in the first trimester of pregnancy. Because animal reproduction studies do not always predict response to human treatment with this drug, this drug should be used during pregnancy by pregnant and lactating women only if needed.

The effects of clindamycin capsules in breastfeeding mothers

Clindamycin has been reported to appear in breast milk in the range of 0.5 to 3.8 μg/mL. Clindamycin has the potential to cause adverse effects on the gastrointestinal flora of infants. If a nursing mother needs this drug or intravenously, it is not a reason to stop breastfeeding, but a better alternative drug may be prescribed to the mother. Monitor the infant for possible adverse effects on the gastrointestinal flora, such as diarrhea, candidiasis, or, rarely, blood in the stool, indicating possible antibiotic-associated colitis.

Storage conditions for clindamycin capsules

Follow product instructions or consult your pharmacist for storage details. As far as possible, keep all medicines out of the reach of children and animals. Store this medicine in a dry, cool place away from heat and direct sunlight. Dispose of this product properly when it has expired or is no longer needed. If you intend to throw away the medicine, do not pour it into the sewer, street or toilet.

Capsule’s last word about clindamycin

In this article from Positive Green Pharmacy magazine, we investigated the role and importance of clindamycin capsules as a new form of drug delivery in the treatment of bacterial infections. This type of drug presentation with its unique features can create significant improvements in treatment efficiency and patient tolerance to the drug. Due to the wide range of antibacterial activity of this drug and its physical and chemical characteristics, these capsules can be used as an effective option in the treatment of various types of infections, including respiratory, skin, urinary and digestive infections.

Site source: Medscape

Frequently asked questions about clindamycin