CLINDAMYCIN

Drugs in Pregnancy and Lactation.

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Name: CLINDAMYCIN
Class: Antibiotic
Risk Factor:    BM

Fetal Risk Summary

No reports linking the use of clindamycin with congenital defects have been located. Reproduction studies in mice and rats with oral doses up to 600 mg/kg/day (about 1.1 and 2.1 times the maximum recommended human adult dose on a mg/m2 basis [MRHD], respectively) revealed no evidence of teratogenicity (1). SC doses in the two species up to 250 mg/kg/day (0.5 and 0.9 times the MRHD, respectively) also failed to show teratogenicity (1).

The drug crosses the placenta, achieving maximum cord serum levels of approximately 50% of the maternal serum (2, 3). Levels in the fetus were considered therapeutic for susceptible pathogens. A study published in 1988 measured a mean cord:maternal ratio of 0.15 in three women given an unknown amount of clindamycin in labor for the treatment of chorioamnionitis (4). At the time of sampling, mean maternal blood, cord blood, and placental membrane concentrations of the antibiotic were 1.67 µg/mL, 0.26 µg/mL, and 1.86 µg/g, respectively (placenta:maternal ratio 1.11). Fetal tissue levels increase following multiple dosing with the drug, concentrating in the fetal liver (2). Maternal serum levels after dosing at various stages of pregnancy were similar to those of nonpregnant patients (3, 5). Clindamycin has been used for prophylactic therapy prior to cesarean section (6).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 647 newborns had been exposed to clindamycin during the 1st trimester (includes both maternal systemic and nonsystemic administration) (F. Rosa, personal communication, FDA, 1993). A total of 31 (4.8%) major birth defects were observed (28 expected). Specific data were available for six defect categories, including (observed/expected) 5/6 cardiovascular defects, 0/1 oral clefts, 1/0.5 spina bifida, 1/2 polydactyly, 0/1 limb reduction defects, and 3/2 hypospadias. These data do not support an association between the drug and congenital defects.

Breast Feeding Summary

Clindamycin is excreted into breast milk. In two patients receiving 600 mg IV every 6 hours, milk levels varied from 2.1–3.8 µg/mL (0.2–3.5 hours after drug) (7). When the patients were changed to 300 mg orally every 6 hours, levels varied from 0.7–1.8 µg/mL (2–7 hours after drug). Maternal serum levels were not given.

Two grossly bloody stools were observed in a nursing infant whose mother was receiving clindamycin and gentamicin (8). No relationship to either drug could be established. However, the condition cleared rapidly when breast feeding was stopped. Except for this one case, no other adverse effects in nursing infants have been reported.

Three potential problems that may exist for the nursing infant are modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. The American Academy of Pediatrics considers clindamycin to be compatible with breast feeding (9).

"Official medicines" is the best online drugstore.

World’s leading meds delivered to your door – and you don’t even need a prescription! Only certified, first class drugs on offer! Buy more and spend less with our great discount system.

References

  1. Product information. Cleocin. Pharmacia & Upjohn, 2000.
  2. Philipson A, Sabath LD, Charles D. Transplacental passage of erythromycin and clindamycin. N Engl J Med 1973;288:1219–21.
  3. Weinstein AJ, Gibbs RS, Gallagher M. Placental transfer of clindamycin and gentamicin in term pregnancy. Am J Obstet Gynecol 1976;124:688–91.
  4. Gilstrap LC III, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol 1988;72:124–5.
  5. Philipson A, Sabath LD, Charles D. Erythromycin and clindamycin absorption and elimination in pregnant women. Clin Pharmacol Ther 1976;19:68–77.
  6. Rehu M, Jahkola M. Prophylactic antibiotics in caesarean section: effect of a short preoperative course of benzyl penicillin or clindamycin plus gentamicin on postoperative infectious morbidity. Ann Clin Res 1980;12:45–8.
  7. Smith JA, Morgan JR, Rachlis AR, Papsin FR. Clindamycin in human breast milk. Can Med Assoc J 1975;112:806.
  8. Mann CF. Clindamycin and breast-feeding. Pediatrics 1980;66:1030–1.
  9. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.

Index

Q&A about Clindamycin

anunaki7...
Clindamycin?
I applied two coats of topical Clindamycin solution to my chin...

After doing some research I found that this junk can cause colitis and intestinal problems when absorbed into the bloodstream...and could not appear for up to weeks

I am discontinuing use...

But what are the chances that I could develop intestinal problems?

I don't want to be a nervous wreck every time I feel sick or get diareah for the next month
LIZ
Very little chance. Pseudomembranous colitis mainly occurs with the oral use of this drug (i.e., tablets/capsules). Dont worry nothing will happen.
Da Man
Can Clindamycin be used for male cats bladder infection and how many milligrams for a 20 pound cat?
I have a 7 year old male cat. He has a bladder infection, is Clindamycin the drug of treatment for him. He weighs approximately 20 pounds. How many milligrams would i give him if this is the correct medication?
Tigerluv...
you need to take the cat to a vet and have them tell you if it is a bladder infection and have him give you a prescription in the correct amount for the cat. If you just give your cat medication for a sickness and are unsure of the real illness you could make him sicker.
Lucas H.
What type of antibiotics are safe for dogs besides Clindamycin?
Dog has a head wound and needs antibiotics, and I am wondering what other types there are for dogs besides Clindamycin?
**ICE QUEEN**
jonas_ho...
How long does novo-clindamycin take to being taking effect?
I have a cavity which turned into a painful infection. Because im allergic to penacilin, I was prescribed novo-clindamycin to be taken 4 times a day (every six hours) and I will be taking by 6th pill at 11pm tonight, but I have not noticed any decrease in the swelling or pain yet. How long does it normally take for the swelling to start going down? At what point do I need to call the dentist and let her know that the medication is not helping?
RDH
Penicillin is the fastest acting antibiotic for dental infection. Since you are allergic, clindamycin was prescribed, which is slower-acting. It may take about 3 days before you get relief. It is important to finish the entire course of antibiotics. Many people stop taking them when they start to feel better. But that doesn't mean the infection has been knocked it. It can come back even worse! I hope you feel better soon; you should.
skibum_u...
I need to figure out what other medication my cat can have as an alternative to clindamycin?
He is currently on clindamycin drops for a sore on his nose. But it is giving him diarria. I won't see the doc till tuesday so I was wondering what the next step would be?
BlueXJ
Amoxicillin also called clavamox. You can always give your cat a few drops of Immodium to curtail the runs that are associated with most antibiotics. Just about two or three drops once a day depending upon your cats weight. 2 for a small to average cat and 3 for a heavy cat.
Bev B
Is there a more effective antibiotic for a cat gum infection than clindamycin?
My leukemia positive 13 yr old cat has a gum infection and is on clindamycin and it doesn't seem to be improving. Is there something better.
?
Clindamyacin was prescribed for me to clear up a case of Oral Thrush after I used my corticosteroid inhaler( QVAR) for my Asthma. It might not be the right antibiotic that your cat needs if it isnt working, check back with the vet and see if there is something else. Hope it does as I have 2 cats my self and would be crushed if the dr gave me the wrong meds for them that didnt work quickly.
brandili...
I have a question about clindamycin and colitis?
I have been taking clindamycin for 6 days now, i take 4 times a day and its the 300mg strength. The past 3 days I ahve been having very loose and watery stool, i have been nauseous and feeling very weak and light headed. I have taken clindaymicin about 4 other times in the past 6 months. Could I have colitis? When should I see a doctor. Is there a good chance of getting colitis whilte taking the drug?
nicedoc
You should let your doctor know about this. A complication of chronic antibiotic therapy, especially with clindamycin is a colitis involving C. Difficile. Basically, the antibiotics kill off most of the normal bacteria flora in your gut allowing C. Difficile to flourish, leading to a severe colitis requiring yet another special antibiotic course to get rid of it.
shloime1
Does Clindamycin reduce the efficacy of contraception of a vaginal ring?
I know there may be some anectodal evidence that clindamycin interferes with the effectiveness or oral contraceptives. Does it interfere with contraceptive vaginal rings?
OpalMine
I doubt it, try doing a search on the net
ladybug5...
How long before diarrhea goes away after taking clindamycin?
I was on the antibiotic Clindamycin for 1 week for a tooth infection...after 3 weeks of being off of the antibiotic I started having diarrhea...I have had this for 2 weeks now...been taking Immodium...just started Activia today...having cramps...watery stools...how long does this last?...If not gone away by next weekend am going to Dr....anyone else had this problem and what did you do or what did the Dr. prescribe for you to take to make it go away?...Thanks
David B
Clindamycin is the worst antibiotic for causing Pseudomembraneous colitis. You should see your family provider for testing of your stool for C-diff and WBC's. If you have C-diff, another antibiotic, Metronidazole or Vancomycin will be needed to clear it up. Then you can use the probiotics, like yogurt. Good luck.
Cynthia L
Clindamycin Hydrochloride Drops antibiotic if perscribed for a cat is it good for a dog?
My dogs tail has a sore on it and Hydrochordizone seems to relieve the itch but it does not disappear. Plus he has anal gland issues which my vet said I could do it but I forgot howl. Please help me.
redhotzz
I would not mix meds on pets unless a vet says it's ok. Their livers are totally different and what you can use on one, you can't on the other sometimes.

I know nothing about the anal gland issue but certainly a yahoo search will get you half a million or so hits on how to do what you need to.