Cleocin (clindamycin) is a lincosamide antibiotic prescribed for the treatment of serious infections caused by anaerobic bacteria and certain susceptible strains of aerobic gram-positive cocci. It is a critical therapeutic agent in both hospital and outpatient settings, particularly when penicillin is contraindicated or ineffective. Available in oral capsules, topical solutions, and injectable forms, Cleocin provides clinicians with a versatile tool to combat a range of moderate to severe bacterial conditions. Its mechanism involves inhibiting bacterial protein synthesis, effectively halting the growth and spread of pathogenic organisms.

Features

• Active ingredient: Clindamycin phosphate or clindamycin hydrochloride
• Available formulations: Oral capsules (150 mg, 300 mg), topical gel/lotion/solution (1%), vaginal cream (2%), injectable solution
• Mechanism: Bacteriostatic inhibition of protein synthesis at the 50S ribosomal subunit
• Spectrum: Effective against anaerobic bacteria (e.g., Bacteroides, Clostridium), streptococci, staphylococci, and pneumococci
• Bioavailability: Approximately 90% for oral formulation; not significantly affected by food
• Half-life: 2–3 hours in adults with normal renal/hepatic function

Benefits

• Provides targeted action against anaerobic and gram-positive aerobic bacteria, filling a critical niche in antibiotic therapy
• Offers multiple administration routes (oral, topical, parenteral) for flexible treatment planning based on infection severity and location
• Demonstrates rapid tissue penetration, achieving effective concentrations at sites of infection including bone, joints, and abscess cavities
• Serves as an alternative for penicillin-allergic patients in appropriate clinical scenarios
• Effective against certain antibiotic-resistant strains when susceptibility is confirmed
• Well-established safety profile with decades of clinical use and monitoring

Common use

Cleocin is commonly prescribed for serious infections including: septicemia, intra-abdominal infections (such as peritonitis and abdominal abscesses), lower respiratory tract infections (including pneumonia, lung abscess, and empyema), gynecological infections (pelvic inflammatory disease, endometritis), skin and soft tissue infections, and bone/joint infections. It is also used topically for acne vulgaris and vaginally for bacterial vaginosis. The specific indication depends on the formulation prescribed and should always be guided by culture and susceptibility testing when possible.

Dosage and direction

Adults:

• Serious infections: 150–450 mg orally every 6 hours, or 600–2700 mg/day IV in 2–4 divided doses
• Severe infections: Up to 4800 mg/day IV in divided doses
• Acne vulgaris: Apply thin layer of topical solution to affected area twice daily
• Bacterial vaginosis: One applicatorful (approximately 100 mg clindamycin) intravaginally daily at bedtime for 3 or 7 days depending on product

Pediatric patients:

• Serious infections: 8–25 mg/kg/day orally in 3–4 divided doses, or 15–40 mg/kg/day IV in 3–4 divided doses
• Severe infections: Up to 40 mg/kg/day IV in 3–4 divided doses

Dosage adjustments required for patients with hepatic impairment. Oral administration with a full glass of water to minimize esophageal irritation. Complete the full course of therapy even if symptoms improve earlier.

Precautions

Monitor patients for development of diarrhea throughout therapy and for several weeks after discontinuation. Clindamycin therapy has been associated with Clostridium difficile-associated diarrhea (CDAD), which may range from mild diarrhea to fatal colitis. Use with caution in patients with a history of gastrointestinal disease, particularly colitis. Periodic liver and kidney function tests recommended during prolonged therapy. May cause overgrowth of nonsusceptible organisms, particularly fungi; monitor for superinfection. Topical application may cause irritation, dryness, or peeling of skin; avoid contact with eyes, mouth, and mucous membranes.

Contraindications

Hypersensitivity to clindamycin, lincomycin, or any component of the formulation. History of regional enteritis, ulcerative colitis, or antibiotic-associated colitis. Not for intrathecal administration. Concomitant use with erythromycin due to potential antagonism.

Possible side effect

Common: Nausea, vomiting, diarrhea, abdominal pain, skin rash, itching. Less common: Esophagitis, unpleasant or metallic taste, neutropenia, eosinophilia, thrombocytopenia. Rare but serious: Severe colitis (pseudomembranous colitis), anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatitis, jaundice, polyarthritis. Topical: Dryness, peeling, burning, itching, erythema, oiliness. Vaginal: Vulvovaginal irritation, itching, discharge.

Drug interaction

May enhance neuromuscular blocking activity of neuromuscular blocking agents. Antagonism may occur with erythromycin and chloramphenicol. May decrease cyclosporine levels. Kaolin-pectin may decrease absorption of oral clindamycin.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for the missed one. Maintain regular dosing intervals for optimal therapeutic effect.

Overdose

Symptoms may include severe nausea, vomiting, abdominal cramps, and diarrhea. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin. Treatment is supportive and symptomatic. In cases of CDAD, discontinue therapy and consider appropriate treatment including fluids, electrolytes, protein supplementation, and oral vancomycin or metronidazole if indicated.

Storage

Store at room temperature (20–25°C or 68–77°F). Oral capsules: Keep container tightly closed. Protect from light and moisture. Topical solutions: Keep tube tightly closed. Injectable solutions: Follow specific storage instructions provided with product. Keep all medications out of reach of children.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment recommendations. The prescribing physician should be familiar with the complete prescribing information before initiating therapy. Antibiotics should only be used when clearly indicated to reduce the risk of antibiotic resistance.

Reviews

“Cleocin has been a reliable option in our surgical prophylaxis protocol, particularly for patients with penicillin allergies. Its anaerobic coverage is excellent for abdominal procedures.” — General Surgeon, 15 years experience

“I’ve prescribed topical clindamycin for moderate inflammatory acne for years with consistent results. Patients appreciate the reduction in inflammatory lesions with minimal systemic side effects.” — Dermatologist, 12 years experience

“While effective, we remain vigilant for C. difficile with any clindamycin course. Our institution has protocols for monitoring and early intervention when needed.” — Infectious Disease Specialist, 20 years experience

“Oral cleocin resolved my severe dental abscess when penicillin failed. The treatment was effective though I experienced some gastrointestinal discomfort.” — Patient review