Cleocin
Compatibility of clindamycin phosphate with aztreonam in polypropylene syringes and with cefoperazone sodium, cefonicid sodium, and cefuroxime sodium in partial-fill glass bottles.

Marble DA, Bosso JA, Townsend RJ.

Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City 84112.

The stability and compatibility of clindamycin phosphate admixed with four beta-lactams, an experimental monobactam (aztreonam), and three cephalosporins (cefoperazone sodium, cefonicid sodium, and cefuroxime sodium), were studied. Aztreonam alone and the combination of clindamycin phosphate-aztreonam were prepared in duplicate polypropylene syringes. Each cephalosporin antibiotic as well as the three clindamycin phosphate-cephalosporin combinations were admixed in duplicate 100 ml partial-fill glass bottles containing either dextrose 5% in water or NaCl 0.9%. All solutions were examined, antibiotic concentrations were determined, and pH was measured at the time of admixture and 1, 4, 8, 12, 24, and 48 hours later. The solutions were maintained at room temperature under fluorescent lighting for the length of the study. Antibiotic concentrations were determined by drug-specific high performance liquid chromatographic assays. Significant instability or incompatibility was defined as a decrease in concentration of greater than ten percent relative to the initial concentration measured at the time of admixture. All antibiotics were stable for 48 hours. In the combination studies, clindamycin was stable for 48 hours, both in partial-fill glass bottles and syringes. Aztreonam, cefoperazone, cefonicid, and cefuroxime were also stable for 48 hours.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3349921&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Duration of therapeutic levels of intravitreally injected liposome-encapsulated clindamycin in the rabbit.

Fiscella R, Peyman GA, Fishman PH.

Department of Ophthalmology, Eye and Ear Infirmary, University of Illinois College of Medicine, Chicago.

We investigated an intravitreal preparation of liposome-encapsulated clindamycin phosphate to determine the duration of therapeutic levels of the drug in the vitreous cavity. Twenty New Zealand albino rabbits were given an intravitreal injection of 750 micrograms/0.1 mL of encapsulated clindamycin (10 animals) or 800 micrograms/0.1 mL of nonencapsulated clindamycin (10 animals) and then were killed immediately or 6, 12, 24 or 48 hours later. The mean concentration of encapsulated clindamycin in the vitreous at 48 hours was 28.4 micrograms/mL, while that of nonencapsulated clindamycin at 24 hours was 2.3 micrograms/mL. The estimated elimination rate of nonencapsulated clindamycin was 3 hours, compared with approximately 10 hours for the encapsulated preparation. This drug delivery system warrants further investigation for possible use in humans.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3427538&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Compatibility and stability of clindamycin phosphate-aminoglycoside combinations within polypropylene syringes.

Zbrozek AS, Marble DA, Bosso JA, Bair JN, Townsend RJ.

Department of Pharmacy Practice, College of Pharmacy, University of Utah, Salt Lake City 84112.

The stability and compatibility of clindamycin phosphate admixed separately with gentamicin sulfate, tobramycin sulfate, and amikacin sulfate in polypropylene syringes under specific storage conditions were studied. In duplicate syringes, clindamycin phosphate 900 mg was admixed with sterile NaCl 0.9% l ml and with either gentamicin sulfate 120 mg, tobramycin sulfate 120 mg, or amikacin sulfate 750 mg. In duplicate polypropylene syringes, control solutions of clindamycin phosphate and each aminoglycoside were prepared separately and stored under the same conditions. The clindamycin control consisted of clindamycin phosphate 900 mg in 6 ml. The gentamicin and tobramycin controls consisted of gentamicin sulfate and tobramycin sulfate 120 mg in 3 ml plus 1 ml of sterile NaCl 0.9%. The amikacin control consisted of amikacin sulfate 750 mg in 3 ml plus 1 ml of sterile NaCl 0.9%. Drug concentrations were determined at the time of preparation and 1, 4, 8, 12, 24, and 48 hours thereafter. Aminoglycosides were assayed by fluorescence polarization immunoassay and clindamycin was assayed by high performance liquid chromatography. Visual inspections and pH determinations of each combination and control solution were performed at each assay time. For the clindamycin, gentamicin, tobramycin, and amikacin control solutions, changes in concentration were within ten percent of the original concentration. Concentrations of clindamycin and gentamicin when admixed together also remained within ten percent of the original concentration. Similar results were found with concentrations of clindamycin and amikacin when admixed together. Tobramycin and clindamycin formed a lasting precipitate upon initial contact when admixed under the study conditions.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3428140&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Effect of clindamycin on the ability of a continuous culture of colonic bacteria to ferment carbohydrate.

Edwards CA, Duerden BI, Read NW.

A continuous culture model of the proximal colon was used to study the effect of clindamycin on the ability of colonic bacteria to ferment carbohydrate. Six steady state anaerobic cultures of human faeces, in a medium simulating ileostomy effluent, were treated with 26 micrograms/ml clindamycin. They were paired with six untreated cultures, run under identical conditions. Clindamycin treatment eliminated the anaerobic bacteria, significantly decreased osmolality and the output of volatile fatty acids, particularly propionic acid and increased the residual carbohydrate concentration. Doubling the amount of carbohydrate in the medium increased osmolality and the production of volatile fatty acid, though the response of clindamycin treated cultures was less than that of untreated cultures. Attempts to introduce Clostridium difficile into three pairs of cultures were successful in only two cultures after administration with clindamycin and when a heavy inoculum (10(6)-10(9) organisms) had been used.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3514388&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
[Lincosamides]

[Article in French]

Pechere JC.

The two main antibiotics that make up the group of lincosamides are lincomycin and its more recent derivative clindamycin; the latter, more active drug is gaining preference over the former. These antibiotics are active primarily against Gram positive cocci (i.e. staphylococci, pneumococci and group A and unclassifiable streptococci) and against most anaerobes (including Bacteroides fragilis). This action originates in binding to the 50S ribosomal fraction. Lincosamides may be given per os, intramuscularly or intravenously. After an oral dose of clindamycin, 90% of the drug is absorbed, and the peak serum level is reached within the first hour. Drug absorption is not modified by meals. Regardless of the route of administration, the serum half life of clindamycin is 2 to 3.8 hours in healthy individuals. Longer half lives are observed in patients with severe renal or hepatic failure, requiring that lower dosages be given by widening the intervals between doses. Diffusion of lincosamides into tissues is of clinical significance except for the central nervous system, especially the cerebrospinal fluid. On the whole, lincosamides are well tolerated. Pseudomembranous colitis is a potential hazard. The main indications of clindamycin are infections due to anaerobes, especially intestinal and vaginal infections. As clindamycin has virtually no effect against Gram negative aerobic pathogens, in most instances another antibiotic, usually an aminoglycoside, is given simultaneously. Other less common indications are some instances of aspiration pneumonia, septicemias due to B. fragilis, and actinomycoses. Because of the risk of pseudomembranous colitis, prophylactic use of clindamycin to prevent postoperative infections following colorectal surgery seems unadvisable.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3517777&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Effect of Bacteroides fragilis grown in the presence of clindamycin, metronidazole and fusidic acid on opsonization and killing of Escherichia coli.

Namavar F, Kaan JA, Verweij-van Vught AM, Vel WA, Bal M, Kester AD, MacLaren DM.

Bactericidal action of human polymorphonuclear leucocytes on Escherichia coli in the presence of Bacteroides fragilis grown in subinhibitory concentrations of clindamycin, metronidazole and fusidic acid was studied. Bacteroides fragilis grown in the absence of drugs significantly inhibited the killing of Escherichia coli. Bacteroides fragilis grown in the presence of the drugs had a reduced inhibitory effect on the killing of Escherichia coli but this reduction was only significant for Bacteroides fragilis grown in 1/2 MIC of clindamycin. The phagocytosis of Bacteroides fragilis grown with and without clindamycin, as measured by killing, was the same. Complement consumption of Bacteroides fragilis grown with and without clindamycin did not differ. Clindamycin-treated Bacteroides fragilis fixed C3 to a significantly lower degree than did untreated bacteria. The chemiluminescence of Escherichia coli opsonized with serum preincubated with clindamycin-treated Bacteroides fragilis was significantly higher than with serum preincubated with untreated bacteria. These results suggested that in killing experiments of mixed Escherichia coli and Bacteroides fragilis, the mechanism underlying the reduced inhibitory capacity of clindamycin-exposed Bacteroides fragilis is related to greater availability of C3 in serum for opsonization of Escherichia coli.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3527702&dopt=Abstract clindamycin antibiotic Cleocin-T