2018, Vol 14, Suppl 1
Clindamycin – a complete drug monograph
Pediatr Med Rodz 2018, 14 (Suppl. 1), p. s1–s15
DOI: 10.15557/PiMR.2018.s1.0001

Clindamycin is a semisynthetic chlorine derivative of lincomycin with a number of benefits when compared to its precursor. It has been available for treatment since 1966. As macrolides and streptogramins B, clindamycin exerts bacteriostatic effects by affecting the 50S ribosomal subunit of sensitive bacteria. Also, it blocks toxin synthesis and restricts virulence of dangerous bacteria, such as Streptococcus pyogenes and Staphylococcus aureus. It is active against Gram-positive cocci, except for enterococci, and against most anaerobic both Gram-positive and Gram-negative bacteria. It also has antiprotozoal effects against Pneumocystis or Toxoplasma. Bacterial clindamycin resistance has been growing in certain species, such as Streptococcus pneumoniae or Bacteroides fragilis, which is usually associated with modification of the target binding site, efflux pump activity or enzymatic inactivation of the drug. Clindamycin is available in Poland in many forms. It is characterised by very good bioavailability after oral administration and good tissue distribution (except for the central nervous system). It is eliminated mainly with bile. Adverse events of clindamycin are not usually severe, but diarrhoea or rash are relatively common. Pseudomembranous colitis induced by Clostridium difficile is a serious complication of the therapy with this drug. Clindamycin may be applied for various clinical indications. However, it is frequently a second-line drug in infections or pharmacoprophylaxis. The activity against methicillin-resistant staphylococci and anaerobic bacteria puts it in the first line of treatment for infections with this aetiology.

Keywords: lincosamide antibiotics, clindamycin, lincosamides, MLSB resistance