Lincosamide antibiotic
Updated · Methodology
Second line
Lactational mastitis with penicillin intolerance or suspected MRSA. Per ABM Protocol #36 2022 and SEGO 2023, second-line 300–450 mg 4 times daily for 10–14 days. Particularly indicated for community-acquired MRSA (CA-MRSA) – usually clindamycin-susceptible, unlike hospital MRSA.
Sources
ICD-10: O91.2 · ICD-11: JB45.1
Binds the 50S ribosomal subunit and blocks protein synthesis. Active against gram-positive cocci (including community-acquired MRSA), anaerobes. Bioavailability 90%, penetrates bone and abscesses. Reserve for penicillin allergy and suspected MRSA.
Boxed warning
FDA black box: increased risk of severe C. difficile colitis.
Safe in pregnancy.
Compatible. Hale L2. RID about 1.4%, T½ 2.4 h. Possible infant diarrhea – monitor stools. With prolonged courses, infant C. difficile risk also rises – observe.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Verbatim lines from the interaction sections, in the language of the label
«Clindamicina posee propiedades bloqueantes neuromusculares y puede potenciar la acción de relajantes musculares no despolarizantes, como los agentes curarizantes (pancuronio, tubocurarina…»AEMPS, section 4.5 · Open on CIMA
«Drug Interactions: Clindamycin is metabolized predominantly by CYP3A4, and to a lesser extent by CYP3A5, to the major metabolite clindamycin sulfoxide and minor metabolite N-desmethylclindamycin…»FDA, section 7 · Open on DailyMed
«Drug Interactions: Clindamycin is metabolized predominantly by CYP3A4, and to a lesser extent by CYP3A5, to the major metabolite clindamycin sulfoxide and minor metabolite N-desmethylclindamycin…»FDA, section 7 · Open on DailyMed
«Drug Interactions: Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents. Therefore, it should be used with caution…»FDA, section 7 · Open on DailyMed
«Clindamicina posee propiedades bloqueantes neuromusculares y puede potenciar la acción de relajantes musculares no despolarizantes, como los agentes curarizantes (pancuronio, tubocurarina…»AEMPS, section 4.5 · Open on CIMA
«Drug Interactions: Clindamycin is metabolized predominantly by CYP3A4, and to a lesser extent by CYP3A5, to the major metabolite clindamycin sulfoxide and minor metabolite N-desmethylclindamycin…»FDA, section 7 · Open on DailyMed
«Se ha demostrado antagonismo in vitro entre clindamicina y eritromicina, motivo por el que habitualmente no se administran ambos antibióticos simultáneamente. Así mismo, existen datos que sugieren…»AEMPS, section 4.5 · Open on CIMA
«Antagonistas de la vitamina K»AEMPS, section 4.5 · Open on CIMA
«Se ha demostrado antagonismo in vitro entre clindamicina y eritromicina, motivo por el que habitualmente no se administran ambos antibióticos simultáneamente. Así mismo, existen datos que sugieren…»AEMPS, section 4.5 · Open on CIMA
«Se han notificado casos de incremento en los valores de las pruebas de coagulación (TP/AEMPS, section 4.5 · Open on CIMA
«Clindamicina: puede incrementar la actividad anticoagulante con incremento en los valores de las pruebas de coagulación (TP/AEMPS, section 4.5 · Open on CIMA
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Clindamycin is evaluated for the following indications with varying evidence strength: Lactational mastitis (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Clindamycin (≥ 1 in 100): Diarrhea (10–30%), Nausea, Metallic taste, Skin rash, Vaginal candidiasis. See the Safety section for uncommon and serious reactions.
Safe in pregnancy.
Compatible. Hale L2. RID about 1.4%, T½ 2.4 h. Possible infant diarrhea – monitor stools. With prolonged courses, infant C. difficile risk also rises – observe.
Clindamycin is contraindicated in: Anaphylaxis to clindamycin or lincomycin; History of inflammatory bowel disease (relative). Full list in the Safety section.
FDA black box: increased risk of severe C. difficile colitis.
Direct links to regulator labels. Open in a new tab.
Co-trimoxazole, Daptomycin, Doxycycline, Erythromycin, Flucloxacillin, Meropenem, Amoxicillin + Clavulanic Acid, Ceftriaxone