Clindamycin is active against streptococci, staphylococci, bacteroides species and other anaerobes, both grampositive and gram-negative. It resembles erythromycin in activity and mechanisms of resistance. Clindamycin is well absorbed orally and about 90% protein-bound. Excretion is mainly via the liver, bile, and urine. It penetrates well into most tissues.
Clinical uses: Clindamycin is used for the treatment of severe anaerobic infection caused by Bacteroides. It is used for prophylaxis of endocarditis in patients with valvular heart disease who are undergoing certain dental procedures. Clindamycin plus primaquine is an effective for moderate to moderately severe Pneumocystis carinii pneumonia. It is also used in combination with pyrimethamine for AIDS-related toxoplasmosis of the brain.
Adverse effects: Diarrheas, nausea, and skin rashes, impaired liver functions are common. Severe diarrhea and enterocolitis is caused by toxigenic C difficile (infrequently part of the normal fecal flora but is selected out during administration of oral antibiotics).
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