What is this medication?
Clindamycin/Dalacin/Cleocin is used on and off label for various infections depending on your common local bacterial strains for various infections and based on local resistance patterns. Not all antibiotics work for all infections and efficacy can vary from area to area and vary with time. It is common in North America for use in bacterial vaginosis (off-label), diabetic foot infections (off-label), endocarditis prophylaxis (off-label), osteomyelitis, pneumonia (off-label), soft tissue infections, etc.
“ALERT: US Boxed Warning
Clostridioides (formerly Clostridium) difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile.
Because clindamycin therapy has been associated with severe colitis, which may end fatally, reserve it for serious infections for which less toxic antimicrobial agents are inappropriate. Do not use clindamycin in patients with nonbacterial infections, such as most upper respiratory tract infections.
C. difficile produces toxins A and B, which contribute to the development of CDAD. Hypertoxin-producing strains of C. difficilecause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary because CDAD has been reported to occur more than 2 months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Institute appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation as clinically indicated.”
How does this medication work?
Clindamycin/Dalacin/Cleocin binds to ribosomal 50S subunits of certain bacteria thereby stopping protein synthesis for the cell eventually resulting in cell death. May be bacteriostatic (prevents reproduction) or bactericidal (directly kills live bacteria) depending on dosage.
How should I take this medication?
Oral: 600mg-2400mg divided into two to four daily doses depending on the condition it is used for
How to Take: Follow instructions provided by physician/pharmacy label, swallow whole with a whole glass of water, take consistently at same times each unless otherwise directed, store at room temperature. Can be with or without food but food may reduce risk of gastrointestinal side effects.
You Need to Avoid: Do not lay down for 15 minutes after dosing to prevent reflux to minimize risk of esophageal damage.
What should I watch for while using this medication?
Before starting Clindamycin/Dalacin/Cleocin make sure your physician is aware of any allergies or medications you currently take, if you have liver disease, gastrointestinal disease (e.g. colitis), if you are pregnant, breastfeeding.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
Rash, abdominal pain, diarrhea, nausea (note this is not a complete list of side effects)
Clindamycin is a broad-spectrum antibiotic (kills many kinds of bacteria) which means it can increase risk of opportunistic superinfection such as C. difficile associated diarrhea.
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