Cleocin
In vivo potentiation of polymorphonuclear leukocyte chemotaxis by clindamycin.

Skoutelis AT, Lianou PE, Bassaris HP.

Dept. of Medicine, University of Patras, School of Medicine, Greece.

Polymorphonuclear leukocyte (PMNL) chemotaxis was evaluated in ten healthy volunteers who had received 600 mg of clindamycin intramuscularly. Serum obtained 3 hours after the administration of clindamycin significantly increased PMNL chemotaxis. Serum obtained at 12 and 24 hours after the administration of the drug did not induce significant increase in PMNL chemotaxis. The administration of clindamycin had no direct effect on the PMNLs in terms of their chemotactic activity. These results demonstrate serum-associated augmentation of PMNL chemotaxis by clindamycin in vivo which may be of potential clinical benefit in the outcome of infections.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8300250&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Increased resistance of encapsulated Bacteroides fragilis to clindamycin.

Brook I, Gillmore JD.

Naval Medical Research Institute, Bethesda, Md.

The antimicrobial susceptibility and in vitro growth curve of 4 nonencapsulated and 4 encapsulated isolates of Bacteroides fragilis were determined for clindamycin. The MIC of the nonencapsulated isolates was 1-2 dilutions less (0.062-0.25 microgram/ml) than the MIC for their encapsulated counterparts (0.25-0.5 microgram/ml). No difference was noted in the bacterial growth of the nonencapsulated or encapsulated isolates when incubated without clindamycin. The decline in the number of nonencapsulated isolates was significantly lower (p < 0.05) as compared to the encapsulated isolates when incubated with 0.1 or 0.4 microgram/ml of clindamycin. These results illustrate the higher susceptibility of nonencapsulated B. fragilis isolates to clindamycin as compared to their encapsulated counterparts. Since B. fragilis becomes more encapsulated during the infectious process, this finding underscores the advantage of early antimicrobial prophylaxis and therapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8306810&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Influence of methylprednisolone on the intracellular antimicrobial activity of erythromycin and clindamycin against Legionella pneumophila.

Higa F, Saito A, Inadome J, Kusano N, Kitsukawa K.

First Department of Internal Medicine, School of Medicine, University of Ryukyus, Okinawa, Japan.

We have investigated the effect of methylprednisolone on the intracellular activity of erythromycin and clindamycin in vitro. An assay system was developed for the determination of intracellular activity of antibiotics against Legionella pneumophila using guinea pig resident alveolar macrophages. Erythromycin at a concentration of 0.625 mg/L (5 x MIC) and clindamycin at a concentration of 8 mg/L (MIC) inhibited the growth of a single strain of L. pneumophila in macrophages, whilst ceftizoxime at a concentration of 0.625 mg/L (5 x MIC) did not. Methylprednisolone at therapeutic concentrations did not affect the intracellular antibacterial activity of either erythromycin or clindamycin against L. pneumophila. We found no direct effect of methylprednisolone on the intracellular antibacterial activity of either erythromycin or clindamycin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8360127&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Adverse cutaneous reactions to pyrimethamine/sulfadiazine and pyrimethamine/clindamycin in patients with AIDS and toxoplasmic encephalitis.

Caumes E, Bocquet H, Guermonprez G, Rogeaux O, Bricaire F, Katlama C, Gentilini M.

Departement des Maladies Infectieuses, Parasitaires, Tropicales, et Sante Publique, Hopital Pitie-Salpetriere, Paris, France.

We assessed the value of clinical and laboratory parameters for predicting the occurrence of skin reactions induced by pyrimethamine/sulfadiazine and pyrimethamine/clindamycin and the effects of continued therapy for patients with these reactions. We retrospectively studied all episodes of toxoplasmic encephalitis in patients with AIDS who were treated with pyrimethamine/sulfadiazine or pyrimethamine/clindamycin. Eighteen (75%) of 24 patients treated with pyrimethamine/sulfadiazine had cutaneous reactions after a mean of 11 days, whereas 15 (58%) of 26 patients treated with pyrimethamine/clindamycin had cutaneous reactions after a mean of 13 days (P = .56). Nine (50%) of the 18 patients continued to be treated with pyrimethamine/sulfadiazine throughout the duration of hypersensitivity, compared with all 15 patients who were treated with pyrimethamine/clindamycin (P = .002). Nine patients had to stop therapy with pyrimethamine/sulfadiazine (two had Stevens-Johnson syndrome and one had Lyell's syndrome). Thus, treatment throughout the duration of hypersensitivity is more likely to succeed for patients receiving pyrimethamine/clindamycin, whereas therapy with pyrimethamine/sulfadiazine is associated with a high risk of Lyell's syndrome and Stevens-Johnson syndrome.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8527561&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
[Antibiotic resistance to erythromycin, clindamycin and tetracycline of 573 strains of Streptococcus pyogenes (1992-1994)]

[Article in Spanish]

Orden B, Martinez R, Lopez de los Mozos A, Franco A.

Centro de Especialidades Arguelles, Hospital Puerta de Hierro, Madrid.

BACKGROUND: The aim of this study was to know the antibiotic resistence of Streptococcus pyogenes to erythromycine, clindamycine and/or tetracycline in community samples. The second aim was to determine the existence of multiresistant strains and to know the relationship between resistant strains, clinical samples and age of the patient. METHOD: A retrospective analysis was performed in all the strains of S. pyogenes isolated from January 1992 to December 1994. Antibiotic sensitivity was studied by MIC by the microdilution method using the Pasco semiautomatic system. RESULTS: During the study period 573 beta hemolytic streptococci were identified as S. pyogenes. The global resistance to erythromycine (2.8%), clindamycine (1.4%) and tetracycline (7.3%) remains at low levels but has significantly increased in the case of erythromycine (p < 0.05) and tetracycline (p < 0.05) over these 3 years. The incidence of strains resistant to clindamycine has also increased slowly although this rise is not significant. Five strains (0.9%) were not sensitive to the three antibiotics studied, 4 being isolated in the last trimester of 1994 in pharyngeal exudates. S. pyogenes resistant to erythromycine was most frequently isolated from cutaneous lesions and in pediatric patients (under the age of 14 years). CONCLUSIONS: These results confirm the trend towards an increase in the number of strains of S. pyogenes resistant to erythromycine, clindamycine and/or tetracycline, being most often found in cutaneous lesions and pediatric patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8714154&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Clindamycin therapy of experimental meningitis caused by penicillin- and cephalosporin-resistant Streptococcus pneumoniae.

Paris MM, Shelton S, Trujillo M, Hickey SM, McCracken GH Jr.

University of Texas Southwestern Medical Center at Dallas, USA.

Although penicillin resistance among Streptococcus pneumoniae strains is increasing in many areas, resistance to clindamycin remains low. In our well-characterized rabbit meningitis model, we conducted experiments to evaluate the bacteriologic efficacy of clindamycin after a penicillin- and cephalosporin-resistant S. pneumoniae strain was intracisternally inoculated. Animals received a loading intravenous dose of 30 mg of clindamycin per kg of body weight and then two doses of 20 mg/kg given 5 h apart. In addition to clindamycin, some animals received dexamethasone (DXM) with or without ceftriaxone. The concentrations of clindamycin in cerebrospinal fluid were from 8.9 to 12.8% of the concomitant concentrations in serum and were unaffected by DXM administration. Mean changes in CFU (log10 per milliliter) at 10 and 24 h were -3.7 and -6.1, respectively, for clindamycin-treated rabbits, -3.6 and -6.3 for clindamycin-DXM-treated rabbits, -3.9 and -5.8, respectively, for clindamycin-ceftriaxone-treated rabbits, and -5.0 and -6.7, respectively, for clindamycin-ceftriaxone-DXM-treated rabbits. By 24 h all but one of the cultures of cerebrospinal fluid (that from a clindamycin-DXM-treated rabbit) were sterile. Because of the potential risk for clindamycin-treated rabbits to develop macrolide-lincosamide resistance, we attempted, unsuccessfully, to induce clindamycin resistance in vitro in two S. pneumoniae strains. Although clindamycin therapy might be effective in selected patients with multiple-drug-resistant pneumococcal meningitis who have failed conventional treatments, clinical experience is necessary before it can be recommended.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8787892&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
The potential effect on Neisseria gonorrhoeae of the use of clindamycin vaginal cream in the empirical treatment of vaginal discharge.

Adu-Sarkodie YA, Brook MG, Clark S, Bendall R, Kell PD, Atia WA, Kelsey MC.

Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, UK.

The minimum inhibitory concentrations (MIC) of clindamycin for 62 consecutive isolates of Neisseria gonorrhoeae were found to be 0.03-4 mg/L; the MIC50 and MIC90 were 0.125 and 2.0 mg/L respectively. Seven women treated with clindamycin vaginal cream had cervical mucus samples taken after seven days treatment. The concentrations of clindamycin achieved in the cervical mucus were 30-150 times higher (141-337 mg/L) than the highest MIC of the 62 N. gonorrhoeae isolates. Clindamycin vaginal cream is being used increasingly in Genitourinary Medicine clinics and General Practice for the treatment of bacterial vaginosis. This study shows that clindamycin vaginal cream achieves intra cervical concentrations that are high enough to inhibit N. gonorrhoeae. Empirical use of this therapy should be preceded by urethral and cervical swabs for N. gonorrhoeae in any woman at risk of gonorrhoeae.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8830022&dopt=Abstract clindamycin antibiotic Cleocin-T