Clindamycin

Trade names: e.g. Aclinda™, Clinabeta™, Clindamycin-ratiopharm™, Sobelin™ Drug class: antibiotic

Manufacturer: Clindamycin is manufactured by several different companies. Indications: for HIV patients: mainly toxoplasmic encephalitis (TE) Dose: 600 mg iv every 6 h or 600 mg po every 6 h (always with pyrimethamine for TE therapy). Half dose for (oral) maintenance therapy. In renal failure, reduce dose to a quarter or a third.

Side effects: diarrhea in 10-30 % of patients. Allergies are also frequent and often require discontinuation.

In cases of infection with Clostridium difficile pseudomembranous colitis: the spectrum ranges from mild to severe diarrhea with blood and mucous, leukocytosis, fever and severe abdominal cramps, which may progress to peritonitis, shock and toxic megacolon.

Comments/Warnings: clindamycin is contraindicated in inflammatory bowel disease and antibiotic-induced colitis. Caution with reduced hepatic or renal function and in asthma. No concurrent administration of antiperistaltics! For diarrheas on clindamycin: discontinue and give vancomycin. Internet sources:

USA: http://hiv.net/link.php?id=76 (trade name Cleocin™). References:

1. Dannemann B, McCutchan JA, Israelski D, et al. Treatment of toxoplasmic encephalitis in patients with AIDS. A randomized trial comparing pyrimethamine plus clindamycin to pyrimethamine plus sulfadiazine. Ann Intern Med 1992, 116:33-43. http://amedeo.com/lit.php?id=1727093

2. Katlama C, De Wit S, O'Doherty E, Van Glabeke M, Clumeck N. Pyrimethamine-clindamycin vs. pyrimethamine-sulfadiazine as acute and long-term therapy for toxoplasmic encephalitis in patients with AIDS. Clin Infect Dis 1996, 22:268-75. http://amedeo.com/lit.php?id=8838183

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