CLINDAMYCIN HYDROCHLORIDE - Mar Vista Animal Medical Center

CLINDAMYCIN HYDROCHLORIDE

(for veterinary information only)

BRAND NAME: CLINDADROPS, ANTIROBE, CLEOSIN

AVAILABLE IN
25 mg, 75 m, 150 mg, 300 mg
CAPSULES and TABLETS
AS WELL AS
ORAL SOLUTION

BACKGROUND

The continuing fight against bacterial infections involves the development of antibiotics capable of harming bacterial cells without damaging the patient’s cells. Biological properties that bacteria do not share with animals have been exploited so as to accomplish exactly this.

Clindamycin is an antibiotic of the “lincosamide” class and possesses similar properties to its sister compound “lincomycin.” To understand how the lincosamides work, it is important to understand how proteins are made by cells. The “blueprint” or "code" for any protein structure comes from the cell’s DNA. DNA is basically a sequence of molecules that corresponds to a sequence of amino acids and when these amino acids are strung up in order according to the DNA code, a specific protein is formed. To get from a strand of DNA to a strand of amino acids, the DNA code must be transcribed onto a strand of messenger RNA which is in turn "read" by a cell organ called a ribosome. The ribosome is the key player in the lincosamide antibiotic story as animal ribosomes turn out to be very different from bacterial ribosomes. Because of this difference in ribosome structure, the lincosamide antibiotic is able to destroy the bacterial ribosome without affecting the animal ribosome. In this way, bacteria are not able to manufacture the proteins they need to divide and/or survive yet the patient's ability to make protein is unharmed. Depending on how much antibiotic is used, the bacterial cell may simply be inhibited from reproducing or may be killed outright.

DNA double helix

DNA double helix
(Photocredit: NIH Public Image Library)

HOW THIS MEDICATION IS USED

The lincosamide antibiotics seem to be most useful against the bacteria classified as Gram positive cocci (classified thus based on their shape and cell wall properties). Clindamycin is also helpful against protozoans such as Toxoplasma and Mycoplasma as well as many anaerobic (growing without oxygen) bacteria.

Peptostreptococcus gram positive bacteria

The Gram positive cell wall takes up purple stain. Cocci are round bacteria.
The Gram positive cocci in this picture appear as purple dots.
(Photo credit: CDC Public Health Image Library)

The types of bacteria sensitive to clindamycin makes this drug especially popular for use in oral and periodontal infections, skin infections, and bone infections.

Clindamycin is given once or twice daily and may be given with or without food (see below). Capsules should be "chased" with a syringe of water to prevent the capsule from sticking in the throat/esophagus where it could cause irritation (see below).

SIDE EFFECTS

Oral clindamycin is unpleasant tasting and may be rejected by some patients.

The most common side effect of clindamycin is diarrhea, which is generally not serious and can be mitigated by providing probiotics or a prebiotic meal an hour after medication administration.

More seriously, clindamycin can burn the esophagus if a tablet or capsule sticks during administration. For this reason, a syringe of water or some food should be used to "chase" the medication. In the event of an esophageal burn, the patient will lose appetite, develop difficulty swallowing or may have bloody diarrhea.

INTERACTIONS WITH OTHER DRUGS

Erythromycin, another antibiotic, and clindamycin will be less effective in combination than when used separately. There is some evidence that the same is true when clindamycin is combined with chloramphenicol.

Clindamycin will reduce blood levels of cyclosporine when the two are used concurrently.

CONCERNS AND CAUTIONS

Oral clindamycin is absorbed into the body faster if given on an empty stomach but may be given with or without food.

Clindamycin will cross the placenta if used in pregnant patients. It will also readily be transferred to nursing young and can induce diarrhea.

Dosage may require alteration in patients with kidney or liver disease. In these cases, a different drug might be a better choice. If this is not possible, it may be helpful to measure blood levels of clindamycin to be sure the patient is able to clear the drug adequately and does not overdose.

Liver enzyme blood tests often elevate with the use of clindamycin. This is not felt to be of health significance but is important to recognize when it is seen.

The manufacturer has recommended blood tests of liver and kidney function if use of clindamycin is to persist beyond 30 days.

This medication is not safe for use in horses, rabbits, rodents, or ruminants.

Clindamycin oral liquid is famous for its especially bitter taste. Oral clindamycin is absorbed into the body faster if given on an empty stomach but may be given with or without food.

Clindamycin liquid does not require refrigeration for storage.

Clindamycin tablets may stick in the esophagus on the way down and cause irritation which can lead to potentially serious scarring. This is unlikely to occur except in very small patients but smaller pets should be given a syringe of water after their pill to assure medication arrives in the stomach properly.

Short version (to help us comply with "Lizzie's Law")

Page last updated: 2/24/2022