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This information has been developed and provided by an independent third-party source. Merck & Co., Inc. does not endorse and is not responsible for the accuracy of the content, or for practices or
standards of non-Merck sources.
ALERT: U.S. Boxed Warning
The FDA-approved labeling includes a boxed warning. See Warnings/Precautions section and/or refer to product labeling for additional detail.
Medication Safety Issues
Sound-alike/look-alike issues:
Cleocin® may be confused with bleomycin, Clinoril®, Lincocin®
Pronunciation
(klin da MYE sin)
U.S. Brand Names
Index Terms
Generic Available
Yes: Excludes foam, granules, vaginal suppositories, vaginal cream
Canadian Brand Names
Pharmacologic Category
Pharmacologic Category Synonyms
Use
Treatment against aerobic and anaerobic streptococci (except enterococci), most staphylococci, Bacteroides sp and Actinomyces; bacterial vaginosis (vaginal cream, vaginal suppository); pelvic inflammatory disease (I.V.); topically in treatment of severe acne; vaginally for Gardnerella vaginalis
Use: Dental
Alternate oral antibiotic for prevention of infective endocarditis in individuals allergic to penicillins or ampicillin, when amoxicillin cannot be used; alternate I.M. or I.V. antibiotic for prevention of infective endocarditis in patients allergic to penicillins or ampicillin and unable to take oral medication; alternate oral antibiotic for prophylaxis for dental patients with total joint replacement who are allergic to penicillin; alternate I.V. antibiotic for prophylaxis for dental patients with total joint replacement who are allergic to penicillin and unable to take oral medications; alternate antibiotic in the treatment of common orofacial infections caused by aerobic gram-positive cocci and susceptible anaerobes; treatment of periodontal disease
Use: Unlabeled/Investigational
May be useful in PCP; alternate treatment for toxoplasmosis
Pregnancy Risk Factor
B
Lactation
Enters breast milk/compatible
Contraindications
Hypersensitivity to clindamycin or any component of the formulation; previous pseudomembranous colitis; regional enteritis, ulcerative colitis
Warnings/Precautions
Boxed warnings:
• Colitis: See “Concerns related to adverse effects” below.
Concerns related to adverse effects:
• Colitis: [U.S. Boxed Warning]: Can cause severe and possibly fatal colitis. Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment. Discontinue drug if significant diarrhea, abdominal cramps, or passage of blood and mucus occurs.
Disease-related concerns:
• Hepatic impairment: Use with caution in patients with hepatic impairment; dosage adjustment may be necessary.
Special populations:
• Atopic patients: Use with caution in atopic patients.
Dosage form specific issues:
• Benzyl alcohol: Some products may contain benzyl alcohol which has been associated with "gasping syndrome" in neonates.
• Tartrazine: Some products may contain tartrazine, which may cause allergic reactions in certain individuals.
• Vaginal products: May weaken condoms, or contraceptive diaphragms; barrier contraceptives are not recommended concurrently or for 3-5 days (depending on the product) following treatment.
Adverse Reactions
Systemic:
>10%: Gastrointestinal: Diarrhea, abdominal pain
1% to 10%:
Cardiovascular: Hypotension
Dermatologic: Urticaria, rash, Stevens-Johnson syndrome
Gastrointestinal: Pseudomembranous colitis, nausea, vomiting
Local: Thrombophlebitis, sterile abscess at I.M. injection site
Miscellaneous: Fungal overgrowth, hypersensitivity
<1% (Limited to important or life-threatening): Renal dysfunction (rare), neutropenia, granulocytopenia, thrombocytopenia, polyarthritis
Topical:
>10%: Dermatologic: Dryness, burning, itching, scaliness, erythema, or peeling of skin (lotion, solution); oiliness (gel, lotion)
1% to 10%: Central nervous system: Headache
<1% (Limited to important or life-threatening): Pseudomembranous colitis, nausea, vomiting, diarrhea (severe), abdominal pain, folliculitis, hypersensitivity reactions
Vaginal:
>10%: Genitourinary: Fungal vaginosis, vaginitis or vulvovaginal pruritus (from Candida albicans)
1% to 10%:
Central nervous system: Back pain, headache
Gastrointestinal: Constipation, diarrhea
Genitourinary: Urinary tract infection
Respiratory: Nasopharyngitis
Miscellaneous: Fungal infection
<1% (Limited to important or life-threatening): Atrophic vaginitis, bladder infection, bladder spasm, cervical dysplasia, diarrhea, dizziness, epistaxis, erythema, fever, hypersensitivity, hyperthyroidism, local edema, menstrual disorder, nausea, pain, palpable lymph node, pruritus, pyelonephritis, pyrexia, rash, sciatica, stomach cramps, upper respiratory urticaria, uterine cervical disorder, uterine spasm, vaginal burning, vertigo, vomiting, vulvar erythema, vulvar laceration, wheezing
Drug Interactions
Increased duration of neuromuscular blockade from tubocurarine, pancuronium
Ethanol/Nutrition/Herb Interactions
Food: Peak concentrations may be delayed with food.
Herb/Nutraceutical: St John's wort may decrease clindamycin levels.
Storage
Capsule: Store at room temperature of 20°C to 25°C (68°F to 77°F).
Cream: Store at room temperature.
Foam: Store at room temperature of 20°C to 25°C (68°F to 77°F). Avoid fire, flame, or smoking during or following application.
Gel: Store at room temperature.
Clindagel®: Do not store in direct sunlight.
I.V.: Infusion solution in NS or D5W solution is stable for 16 days at room temperature.
Lotion: Store at room temperature of 20°C to 25°C (68°F to 77°F).
Oral solution: Do not refrigerate reconstituted oral solution (it will thicken). Following reconstitution, oral solution is stable for 2 weeks at room temperature of 20°C to 25°C (68°F to 77°F).
Ovule: Store at room temperature of 15°C to 30°C (68°F to 77°F).
Pledget: Store at room temperature.
Topical solution: Store at room temperature of 20°C to 25°C (68°F to 77°F).
Compatibility
Stable in D5R, D51/2NS, D5NS, D5W, D10W, LR, NS; variable stability (consult detailed reference) in peritoneal dialysis solutions.
Y-site administration: Compatible: Amifostine, amiodarone, amphotericin B cholesteryl sulfate complex, amsacrine, aztreonam, cefpirome sulfate, cisatracurium, cyclophosphamide, diltiazem, docetaxel, doxorubicin liposome, enalaprilat, esmolol, etoposide, fludarabine, foscarnet, gatifloxacin, gemcitabine, granisetron, heparin, hydromorphone, labetalol, levofloxacin, linezolid, magnesium sulfate, melphalan, meperidine, midazolam, morphine, multivitamins, ondansetron, perphenazine, piperacillin/tazobactam, propofol, remifentanil, sargramostim, tacrolimus, teniposide, theophylline, thiotepa, vinorelbine, vitamin B complex with C, zidovudine. Incompatible: Allopurinol, filgrastim, fluconazole, idarubicin.
Compatibility in syringe: Compatible: Amikacin, aztreonam, gentamicin, heparin. Incompatible: Tobramycin.
Compatibility when admixed: Compatible: Amikacin, ampicillin, aztreonam, cefamandole, cefazolin, cefepime, cefoperazone, cefotaxime, cefoxitin, ceftazidime, ceftizoxime, cefuroxime, cephalothin, cimetidine, fluconazole, gentamicin, heparin, hydrocortisone sodium succinate, kanamycin, methylprednisolone sodium succinate, metoclopramide, metronidazole, metronidazole with sodium bicarbonate, ofloxacin, penicillin G, piperacillin, potassium chloride, sodium bicarbonate, tobramycin, verapamil, vitamin B complex with C. Incompatible: Aminophylline, barbiturates, calcium gluconate, ceftriaxone, ciprofloxacin, gentamicin with cefazolin, magnesium sulfate, phenytoin. Variable (consult detailed reference): Ranitidine.
Mechanism of Action
Reversibly binds to 50S ribosomal subunits preventing peptide bond formation thus inhibiting bacterial protein synthesis; bacteriostatic or bactericidal depending on drug concentration, infection site, and organism
Pharmacodynamics/Kinetics
Absorption: Topical: ?10%; Oral: Rapid (90%)
Distribution: High concentrations in bone and urine; no significant levels in CSF, even with inflamed meninges; crosses placenta; enters breast milk
Metabolism: Hepatic
Bioavailability: Topical: <1%
Half-life elimination: Neonates: Premature: 8.7 hours; Full-term: 3.6 hours; Adults: 1.6-5.3 hours (average: 2-3 hours)
Time to peak, serum: Oral: Within 60 minutes; I.M.: 1-3 hours
Excretion: Urine (10%) and feces (?4%) as active drug and metabolites
Dosage
Usual dosage ranges:
Infants and Children:
Oral: 8-20 mg/kg/day as hydrochloride; 8-25 mg/kg/day as palmitate in 3-4 divided doses (minimum dose of palmitate: 37.5 mg 3 times/day)
I.M., I.V.:
<1 month: 15-20 mg/kg/day
>1 month: 20-40 mg/kg/day in 3-4 divided doses
Adults:
Oral: 150-450 mg/dose every 6-8 hours; maximum dose: 1.8 g/day
I.M., I.V.: 1.2-1.8 g/day in 2-4 divided doses; maximum dose: 4.8 g/day
Indication-specific dosing:
Children:
Anthrax: I.V.: 7.5 mg/kg every 6 hours
Babesiosis: Oral: 20-40 mg/kg/day divided every 8 hours for 7 days plus quinine
Orofacial infections:
Oral: 10-20 mg/kg in 3-4 equally divided doses
I.V.: 15-25 mg/kg in 3-4 equally divided doses
Prophylaxis against infective endocarditis (unlabeled use):
Oral: 20 mg/kg 30-60 minutes before procedure
I.M., I.V.: 20 mg/kg 30-60 minutes before procedure. Intramuscular injections should be avoided in patients who are receiving anticoagulant therapy. In these circumstances, orally administered regimens should be given whenever possible. Intravenously administered antibiotics should be used for patients who are unable to tolerate or absorb oral medications.
Note: American Heart Association (AHA) guidelines now recommend prophylaxis only in patients undergoing invasive procedures and in whom underlying cardiac conditions may predispose to a higher risk of adverse outcomes should infection occur. As of April 2007, routine prophylaxis for GI/GU procedures is no longer recommended by the AHA.
Children ?12 years and Adults:
Acne vulgaris: Topical:
Gel, pledget, lotion, solution: Apply a thin film twice daily
Foam (Evoclin™): Apply once daily
Adults:
Amnionitis: I.V.: 450-900 mg every 8 hours
Anthrax: I.V.: 900 mg every 8 hours with ciprofloxacin or doxycycline
Babesiosis:
Oral: 600 mg 3 times/day for 7 days with quinine
I.V.: 1.2 g twice daily
Bacterial vaginosis: Intravaginal:
Suppositories: Insert one ovule (100 mg clindamycin) daily into vagina at bedtime for 3 days
Cream:
Cleocin®: One full applicator inserted intravaginally once daily before bedtime for 3 or 7 consecutive days in nonpregnant patients or for 7 consecutive days in pregnant patients
Clindesse™: One full applicator inserted intravaginally as a single dose at anytime during the day in nonpregnant patients
Bite wounds (canine): Oral: 300 mg 4 times/day with a fluoroquinolone
Gangrenous myositis: I.V.: 900 mg every 8 hours with penicillin G
Group B streptococcus (neonatal prophylaxis): I.V.: 900 mg every 8 hours until delivery
Orofacial/parapharyngeal space infections:
Oral: 150-450 mg every 6 hours for 7 days, maximum 1.8 g/day
I.V.: 600-900 mg every 8 hours
Pelvic inflammatory disease: I.V.: 900 mg every 8 hours with gentamicin 2 mg/kg, then 1.5 mg/kg every 8 hours; continue after discharge with doxycycline 100 mg twice daily to complete 14 days of total therapy
Pneumocystis jiroveci
pneumonia (unlabeled use):
Oral: 300-450 mg 4 times/day with primaquine
I.M., I.V.: 1200-2400 mg/day with pyrimethamine or 600 mg 4 times/day with primaquine
Prophylaxis against infective endocarditis (unlabeled use):
Oral: 600 mg 30-60 minutes before procedure
I.M., I.V.: 600 mg 30-60 minutes before procedure. Intramuscular injections should be avoided in patients who are receiving anticoagulant therapy. In these circumstances, orally administered regimens should be given whenever possible. Intravenously administered antibiotics should be used for patients who are unable to tolerate or absorb oral medications.
Note: American Heart Association (AHA) guidelines now recommend prophylaxis only in patients undergoing invasive procedures and in whom underlying cardiac conditions may predispose to a higher risk of adverse outcomes should infection occur. As of April 2007, routine prophylaxis for GI/GU procedures is no longer recommended by the AHA.
Prophylaxis in total joint replacement patients undergoing dental procedures which produce bacteremia:
Oral: 600 mg 1 hour prior to procedure
I.V.: 600 mg 1 hour prior to procedure (for patients unable to take oral medication)
Toxic shock syndrome: I.V.: 900 mg every 8 hours with penicillin G or ceftriaxone
Toxoplasmosis (unlabeled use): Oral, I.V.: 600 mg every 6 hours with pyrimethamine and folinic acid
Dosing adjustment in renal impairment: No adjustment required.
Dosing adjustment in hepatic impairment: Adjustment recommended in patients with severe hepatic disease
Dental Usual Dosing
Orofacial infection:
Children:
Oral: 10-20 mg/kg in 3-4 equally divided doses
I.V.: 15-25 mg/kg in 3-4 equally divided doses
Adults:
Oral: 150-450 mg/dose for 7 days; maximum dose: 1.8 g/day
I.V.: 600-900 mg every 8 hours
Treatment of periodontal disease: Oral: 300 mg every 8 hours for 8 days
Infective endocarditis prophylaxis:
Children:
Oral: 20 mg/kg 30-60 minutes before procedure
I.M., I.V.: 20 mg/kg 30-60 minutes before procedure. Note: Intramuscular injections should be avoided in patients who are receiving anticoagulant therapy. In these circumstances, orally administered regimens should be given whenever possible. Intravenously administered antibiotics should be used for patients who are unable to tolerate or absorb oral medications.
Adults:
Oral: 600 mg 30-60 minutes before procedure
I.M., I.V.: 600 mg 30-60 minutes before procedure. Note: Intramuscular injections should be avoided in patients who are receiving anticoagulant therapy. In these circumstances, orally administered regimens should be given whenever possible. Intravenously administered antibiotics should be used for patients who are unable to tolerate or absorb oral medications.
Prophylaxis in total joint replacement patients undergoing dental procedures which produce bacteremia:
Adults:
Oral: 600 mg 1 hour prior to procedure
I.V.: 600 mg 1 hour prior to procedure (for patients unable to take oral medication)
Administration: Oral
Administer oral dosage form with a full glass of water to minimize esophageal ulceration. Give around-the-clock to promote less variation in peak and trough serum levels.
Administration: I.M.
Deep I.M. sites, rotate sites. Do not exceed 600 mg in a single injection.
Administration: I.V.
Never administer as bolus; administer by I.V. intermittent infusion over at least 10-60 minutes, at a rate not to exceed 30 mg/minute (not exceed 1200 mg/hour).Final concentration for administration should not exceed 18 mg/mL.
Administration: Topical
Foam: Dispense directly into cap or onto a cool surface. Do not dispense directly into hands.
Administration: Other
Intravaginal:
Cream: Insertion should be as far as possible into the vagina without causing discomfort.
Ovule: The foil should be removed; if the applicator is used for insertion, it should be washed for additional use.
Administration: I.V. Detail
pH: 6.0-6.3 (usual); 5.5-7.0 (range)
Monitoring Parameters
Observe for changes in bowel frequency. Monitor for colitis and resolution of symptoms. During prolonged therapy monitor CBC, liver and renal function tests periodically.
Dietary Considerations
May be taken with food.
Patient Education
I.M., I.V.: Report any burning, pain, swelling, or redness at infusion or injection site.
Oral: Take each dose with a full glass of water. Complete full prescription, even if feeling better. You may experience nausea or vomiting (small, frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help). Report dizziness; persistent GI effects (pain, diarrhea, vomiting); skin redness, rash, or burning; fever; chills; unusual bruising or bleeding; signs of infection; excessive fatigue; yellowing of eyes or skin; change in color of urine or blackened stool; swelling, warmth, or pain in extremities; difficult respirations; bloody or fatty stool (do not take antidiarrheal without consulting prescriber); or lack of improvement or worsening of condition.
Topical, foam: Wash hands thoroughly or wear gloves. Do not dispense directly onto hands or face (foam will begin to melt on contact with warm skin). Dispense an amount the will cover the affected area directly into the cap or onto a cool surface. If can seems warm or foam seems runny, run can under cold water. Pick up small amounts of foam with fingertips and gently massage into affected areas until foam disappears. Wash hands thoroughly. Wait 30 minutes before shaving or applying make-up.
Topical gel, lotion, or solution: Wash hands thoroughly before applying or wear gloves. Apply thin film of gel, lotion, or solution to affected area. May apply porous dressing. Wash hands thoroughly. Wait 30 minutes before shaving or applying make-up. Report persistent burning, swelling, itching, excessive dryness, or worsening of condition.
Vaginal: Wash hands before using. At bedtime: If using applicator, gently insert full applicator into vagina and expel cream. Wash applicator with soap and water following use. If using suppository, insert high into vagina. Remain lying down for 30 minutes following administration. Avoid intercourse during therapy. Report adverse reactions (dizziness, nausea, vomiting, stomach cramps, or headache) or lack of improvement or worsening of condition.
Geriatric Considerations
Clindamycin has not been studied in the elderly; however, since it is eliminated principally by nonrenal mechanisms, major alteration in its pharmacokinetics are not expected. Elderly patients are often at a higher risk for developing serious colitis and require close monitoring.
Anesthesia and Critical Care Concerns/Other Considerations
Clindamycin may increase the duration of neuromuscular blockade after anesthesia. In adults, clindamycin injection can usually be dosed effectively on an every-8-hour basis.
Cardiovascular Considerations
Clindamycin may increase the duration of neuromuscular blockade after anesthesia. Clindamycin may also be considered in the prevention of bacterial endocarditis.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported (see Dental Comment)
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Dental Comment
Clindamycin has not been shown to interfere with oral contraceptive activity; however, it reduces GI microflora, thus, oral contraceptive users should be advised to use additional methods of birth control. About 1% of clindamycin users develop pseudomembranous colitis. Symptoms may occur 2-9 days after initiation of therapy; however, it has never occurred with the 1-dose regimen of clindamycin used to prevent bacterial endocarditis.
Mental Health: Effects on Mental Status
None reported
Mental Health: Effects on Psychiatric Treatment
May cause neutropenia; use caution with clozapine and carbamazepine
Nursing: Physical Assessment/Monitoring
Assess previous allergy history prior to beginning therapy. I.V.: Cardiac status and blood pressure should be monitored and patient kept recumbent after infusion until blood pressure is stabilized. Assess results of laboratory tests and patient response according to dose, route of administration, and purpose of therapy. Teach patient proper use, possible side effects/appropriate interventions, and adverse symptoms to report (eg, severe diarrhea, opportunistic infection).
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Note: Strength is expressed as base
Capsule, as hydrochloride: 75 mg, 150 mg, 300 mg
Cleocin HCl®: 75 mg [contains tartrazine], 150 mg [contains tartrazine], 300 mg
Cream, vaginal, as phosphate:
Cleocin®: 2% (40 g) [contains benzyl alcohol and mineral oil; packaged with 7 disposable applicators]
ClindaMax®: 2% (40 g) [contains benzyl alcohol and mineral oil; packaged with 7 disposable applicators]
Clindesse™: 2% (5 g) [contains mineral oil; prefilled single disposable applicator]
Foam, topical, as phosphate:
Evoclin®: 1% (50 g, 100 g) [contains ethanol 58%]
Gel, topical, as phosphate: 1% (30 g, 60 g)
Cleocin T®: 1% (30 g, 60 g)
Clindagel®: 1% (40 mL, 75 mL)
ClindaMax®: 1% (30 g, 60 g)
Granules for oral solution, as palmitate:
Cleocin Pediatric®: 75 mg/5 mL (100 mL) [cherry flavor]
Infusion, as phosphate [premixed in D5W]:
Cleocin Phosphate®: 300 mg (50 mL); 600 mg (50 mL); 900 mg (50 mL) [contains benzyl alcohol and edentate disodium 0.5 mg/mL]
Injection, solution, as phosphate: 150 mg/mL (2 mL, 4 mL, 6 mL, 60 mL)
Cleocin Phosphate®: 150 mg/mL (2 mL, 4 mL, 6 mL, 60 mL) [contains benzyl alcohol and edetate disodium 0.5 mg/mL]
Lotion, as phosphate: 1% (60 mL)
Cleocin T®, ClindaMax®: 1% (60 mL)
Pledgets, topical: 1% (60s, 69s)
Cleocin T®: 1% (60s) [contains isopropyl alcohol 50%]
ClindaReach™: 1% (120s) [contains isopropyl alcohol 50%; packaged as a kit containing 1 collapsible applicator, 64 appliques, and 64 unmedicated pads]
Solution, topical, as phosphate: 1% (30 mL, 60 mL)
Cleocin T®: 1% (30 mL, 60 mL) [contains isopropyl alcohol 50%]
Suppository, vaginal, as phosphate:
Cleocin® Vaginal Ovule: 100 mg (3s) [contains oleaginous base; single reusable applicator]
Pricing: U.S. (www.drugstore.com)
Capsules (Cleocin)
150 mg (30): $101.84
300 mg (30): $216.68
Capsules (Clindamycin HCl)
150 mg (30): $24.99
300 mg (30): $79.99
Cream (Cleocin)
2% (40): $69.29
Cream (Clindamax)
2% (40): $47.95
Cream (Clindesse)
2% (5.8): $91.20
Foam (Evoclin)
1% (50): $152.44
1% (100): $239.98
Gel (Cleocin-T)
1% (30): $59.99
1% (60): $99.98
Gel (Clindagel)
1% (40): $128.90
1% (75): $210.99
Gel (ClindaMax)
1% (30): $53.73
1% (60): $96.04
Gel (Clindamycin Phosphate)
1% (30): $18.99
1% (60): $51.50
Lotion (Cleocin-T)
1% (60): $77.99
Lotion (ClindaMax)
1% (60): $72.71
Lotion (Clindamycin Phosphate)
1% (60): $45.99
Solution (Cleocin)
75 mg/5 mL (100): $45.99
Solution (Cleocin-T)
1% (30): $32.54
1% (60): $65.99
Solution (Clindamycin Phosphate)
1% (30): $14.99
1% (60): $16.79
Suppository (Cleocin)
100 mg (3): $67.99
Swab (Cleocin-T)
1% (60): $69.99
Swab (Clindamycin Phosphate)
1% (30): $19.99
References
Abramowicz M, “Antimicrobial Prophylaxis in Surgery,” Medical Letter on Drugs and Therapeutics, Handbook of Antimicrobial Therapy, 16th ed, New York, NY: Medical Letter, 2002.
“Advisory Statement. Antibiotic Prophylaxis for Dental Patients With Total Joint Replacements. American Dental Association; American Academy of Orthopedic Surgeons,” J Am Dent Assoc, 1997, 128(7):1004-8.
Centers for Disease Control and Prevention, "Sexually Transmitted Diseases Treatment Guidelines, 2006," MMWR, 2006, 55(RR-11): 1-94.
Dajani AS, Taubert KA, Wilson W, et al, “Prevention of Bacterial Endocarditis. Recommendations by the American Heart Association,” JAMA, 1997, 277(22):1794-801.
Falagas ME and Gorbach SL, “Clindamycin and Metronidazole,” Med Clin North Am, 1995, 79(4):845-67.
Hall G, Nord CE, and Heimdahl A, “Elimination of Bacteraemia After Dental Extraction: Comparison of Erythromycin and Clindamycin for Prophylaxis of Infective Endocarditis,” J Antimicrob Chemother, 1996, 37(4):783-95.
Katlama C, De Wit S, O'Doherty E, et al, “Pyrimethamine-Clindamycin vs Pyrimethamine-Sulfadiazine as Acute and Long-Term Therapy for Toxoplasmic Encephalitis in Patients With AIDS,” Clin Infect Dis, 1996, 22(2):268-75.
Luft BJ, Hafner R, Korzun AH, et al, “Toxoplasmic Encephalitis in Patients With the Acquired Immunodeficiency Syndrome. Members of the ACTG 077p/ANRS 009 Study Team,” N Engl J Med, 1993, 329(14):995-1000.
Safrin S, Finkelstein DM, Feinberg J, et al, “Comparison of Three Regimens for Treatment of Mild-to-Moderate Pneumocystis carinii Pneumonia in Patients With AIDS. A Double-Blind, Randomized, Trial of Oral Trimethoprim-Sulfamethoxazole, Dapsone-Trimethoprim, and Clindamycin-Primaquine. ACTG 108 Study Group,” Ann Intern Med, 1996, 124(9):792-802.
Smilack JD, Wilson WR, and Cockerill FR 3d, “Tetracyclines, Chloramphenicol, Erythromycin, Clindamycin, and Metronidazole,” Mayo Clin Proc, 1991, 66(12):1270-80.
Toma E, Thorne A, Singer J, et al, “Clindamycin With Primaquine vs Trimethoprim-Sulfamethoxazole Therapy for Mild and Moderately Severe Pneumocystis carinii Pneumonia in Patients With AIDS: A Multicenter, Double-Blind, Randomized Trial (CTN 004). CTN-PCP Study Group,” Clin Infect Dis, 1998, 27(3):524-30.
Wilson W, Taubert KA, Gewitz M, et al, “Prevention of Infective Endocarditis. Guidelines From the American Heart Association. A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group,” Circulation, 2007, 115. Available at http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.106.183095v1; last accessed July 26, 2007.
Wynn RL and Bergman SA, “Antibiotics and Their Use in the Treatment of Orofacial Infections, Part I and Part II,” Gen Dent, 1994, 42(5):398-402, 498-502.
Wynn RL, “Clindamycin: An Often Forgotten but Important Antibiotic,” AGD Impact, 1994, 22:10.
Yoshikawa TT, “Antimicrobial Therapy for the Elderly Patient,” J Am Geriatr Soc, 1990, 38(12):1353-72.
International Brand Names
Lexi-Comp.com
Last full review/revision May 2008
Content last modified May 2008
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