Drugs:
Clindamycin; (covers many anaerobic organisms in addition to gram positive organisms) and Lincomycin • can be considered regarding their spectrum a mix of Vancomycin and Metronidazole.
- Reach high concentration in skin
- Direct Effect - mouth infections, osteomyelitis
- Intra-abdominal infection, combined with anaerobic drug B. fragilis
- Septic tract abortion infection
MOA:
Clindamycin binds at a site on the 50S ribosome right next to where the macrolides bind and acts similarly in preventing protein synthesis by preventing the ribosome from moving on to adding another amino acid in the protein chain.
Approximately 90 % of the antibiotic are plasma protein bound. Lincomycin and clindamycin penetrate most tissues well, including bone. Therefore, bone and joint infections caused by susceptible organisms respond well to treatment with clindamycin
Therapeutic uses:
- skin and soft-tissue infections, infections of the oral cavity, and anaerobic intraabdominal infections. It is used topically in the treatment of acne. Clindamycin is a second-line agent (in combination with primaquine) , treatment of P jirovecii pneumonia.
- Severe anaerobic bacterial infections caused by bacteroids especially B. fragilis mixed infections and Female genital system • Missed or septic abortion • Pelvic abcess •
- Treat malaria (in combination with other drugs), to treat bacterial vaginosis, and in the prophylaxis of bacterial endocarditis
Adverse effects:
Gastrointestinal: Diarrhea due to (pseudomembranous colitis)