Cleocin
On the bioavailability of topical formulations of clindamycin hydrochloride.

Franz TJ.

The role of the vehicle in the percutaneous absorption of clindamycin hydrochloride has been studied. Fourteen vehicles have been examined for their ability (1) to adequately solubilize clindamycin and (2) to effect penetration of the drug into the skin. The solubility of clindamycin was found to be good in ten of the fourteen vehicles studied, with a drug concentration of greater than 1.0% being achieved. A vehicular water content of greater than 20% or the presence of another suitable cosolvent appeared to be necessary for adequate solubilization of drug. Percutaneous absorption varied greatly among the vehicles, ranging from 0.7% to 12.9% of the applied dose in 24 hours. The vehicles effecting the greatest clindamycin absorption contained the penetration enhancers dimethylsulfoxide or N-methyl-2-pyrrolidone. Overall, the vehicles studied varied a hundredfold with respect to clindamycin bioavailability. Correlation of these data with other literature data suggests a possible relationship between clindamycin bioavailability and clinical efficacy in the treatment of acne and, therefore, argues against extemporaneous compounding of this drug in the absence of bioavailability data.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6886106&dopt=Abstract clindamycin antibiotic Cleocin-T



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Bacteroides fragilis resistance to clindamycin in vitro.

Sosa A, Tally FP, Jacobus NV, Gorbach SL.

Clindamycin resistance in Bacteroides fragilis was examined in 507 strains isolated from 1973 to 1981. Three groups were recognized: highly susceptible (minimum inhibitory concentration [MIC] less than or equal to 0.125 microgram/ml), intermediately susceptible (MIC = 0.25 to 4 micrograms/ml), and highly resistant to (MIC greater than or equal to 8 microgram/ml). The incidence of high-level resistance (1.8%) had not changed during this period. Only 8 of 17 isolates reputed to be highly clindamycin resistant that were referred to our laboratory proved to be highly resistant (MICs greater than or equal to 32 microgram/ml), whereas the other 9 were intermediately susceptible. Analysis of 2- and 10-microgram clindamycin disks for determining the susceptibility of B. fragilis revealed a high false-resistance rate with the 2-microgram disk, most errors occurring with the intermediate group. There was no false resistance with the 10-microgram disk. When disk diffusion susceptibility of B. fragilis is employed, we recommend the 10-microgram disk to predict accurately the susceptibility of B. fragilis to clindamycin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7181487&dopt=Abstract clindamycin antibiotic Cleocin-T



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Inducible clindamycin resistance in Staphylococci: should clinicians and microbiologists be concerned?

Lewis JS 2nd, Jorgensen JH.

Pharmacy Service, University Health System, Department of Clinical Pharmacy and Pharmacology, University of Texas Health Science Center, San Antonio, Texas 78229, USA.

The increasing incidence of a variety of infections due to Staphylococcus aureus--and, especially, the expanding role of community-associated methicillin-resistant S. aureus (MRSA)--has led to emphasis on the need for safe and effective agents to treat both systemic and localized staphylococcal infections. Unlike most previously noted strains of health care-associated MRSA, community-acquired MRSA isolates are often susceptible to several non- beta -lactam drug classes, although they are usually not susceptible to macrolides. Several newer antimicrobial agents and a few older agents are available for treatment of systemic staphylococcal infections, but use may be limited by the relatively high cost of these agents or the need for parenteral administration. Inexpensive oral agents for treatment of localized, community-acquired MRSA infection include clindamycin, trimethoprim-sulfamethoxazole, and newer tetracyclines. Clindamycin has been used successfully to treat pneumonia and soft-tissue and musculoskeletal infections due to MRSA in adults and children. However, concern over the possibility of emergence of clindamycin resistance during therapy has discouraged some clinicians from prescribing that agent. Simple laboratory testing (e.g., the erythromycin-clindamycin "D-zone" test) can separate strains that have the genetic potential (i.e., the presence of erm genes) to become resistant during therapy from strains that are fully susceptible to clindamycin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15655748&dopt=Abstract clindamycin antibiotic Cleocin-T



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The safety and efficacy of clindamycin phosphate foam 1% versus clindamycin phosphate topical gel 1% for the treatment of acne vulgaris.

Shalita AR, Myers JA, Krochmal L, Yaroshinsky A; Clindamycin Foam Study Group.

Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, NY 11203-2098, USA. ashalita downstate.edu

Clindamycin phosphate is the most widely used topical antibacterial agent for acne treatment. Treatment of patients with mild to moderate acne vulgaris with a new foam formulation (clindamycin foam, CF) for 12 weeks was at least as effective as clindamycin gel (CG) based on the Investigator's Static Global Assessment (ISGA) score. CF was superior to CG based on the reduction from baseline in total (P = .0014), inflammatory (P = .0478), and noninflammatory (P = .0037) acne lesion counts. Additionally, CF achieved efficacy that was superior to that of vehicle foam based on ISGA score (P = .0025) and all 3 lesion counts (all P < .05). Adverse experiences in the active treatment groups were mild or moderate and transient in nature. Thus the foam formulation of clindamycin is a safe and effective acne treatment; the unique foam delivery vehicle may offer cosmetic benefits to the patient and thus increase compliance.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15696985&dopt=Abstract clindamycin antibiotic Cleocin-T



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Recovery of clindamycin from fermentation wastewater with nanofiltration membranes.

Zhu A, Zhu W, Wu Z, Jing Y.

Department of Environmental Science and Engineering, Tsinghua University, Beijing 100084, China. zhuanna00 mails.tsinghua.edu.cn

Experiments were carried out on clindamycin's separation and recovery from clindamycin fermentation wastewater with nanofiltration (NF) membranes. Four types of flat-sheet NF membranes, DLNF-1, NTR-7250, XCNF-1 and MPF-44, were tested under different dynamic operating conditions. It was found that the operating pressure and solute concentration had great influence on membrane performance while flow rates (or velocities) had little influence on membrane performance. Experiments on SO4(2-) rejection were conducted with such four flat-sheet NF membranes because SO4(2-) had bad influence on microbes in biochemical process following the NF process. The results indicated that DLNF-1 and MPF-44 membranes had higher SO4(2-) rejection among four membranes. Two spiral membranes, MPS-44 (1.4 m2) and DLNF2-30 (0.24 m2), were adopted in a concentrating process for clindamycin's separation and recovery from clindamycin fermentation wastewater under laboratory conditions. After being operated for 60h, clindamycin wastewater was concentrated from 266 to 26L, and the clindamycin was concentrated from 220 to 1940 mg/L, which met the demand of reuse. This research may widen the application of NF membranes in disposal of pharmaceutical wastewater.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12867340&dopt=Abstract clindamycin antibiotic Cleocin-T



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Differential Toxicity of Reactive Metabolites of Clindamycin and Sulfonamides in HIV-Infected Cells: Influence of HIV Infection on Clindamycin Toxicity In Vitro.

Wijsman JA, Dekaban GA, Rieder MJ.

Division of Clinical Pharmacology, Department of Paediatrics, Children's Hospital of Western Ontario, 800 Commissioner's Road East, London, Ontario, Canada.

Hypersensitivity adverse drug reactions are much more common among patients with acquired immunodeficiency syndrome (AIDS) than in the general population. High rates of hypersensitivity reactions to clindamycin have been noted. To investigate the role of reactive metabolites in these reactions, the authors studied toxicity of clindamycin and sulphamethoxazole (SMX) and their metabolites in uninfected and human immunodeficiency virus (HIV)-infected MOLT3 cells. Infected and uninfected cells were incubated with clindamycin or sulphamethoxazole hydroxylamine in increasing concentrations; reactive metabolites were generated by coincubation of cells and drug with murine microsomes and a microsomal activating system. Over a concentration range of 0 to 400 muM SMX-HA, there was a significant concentration-dependent increase in cell death in HIV-infected compared to uninfected cells (28%+/-3% vs 8%+/-5% at 400 muM, P < .05). In contrast, coincubation of cells with clindamycin, microsomes, and a microsomal activating system, as well as combinations of primaquine or pyrimethamine, was not associated with an increase in cell death among infected compared to uninfected cells. No concentration-toxicity was demonstrated. These data support the role of reactive metabolites in adverse drug reactions to sulfonamides during HIV infection, whereas alternate mechanism(s) may be responsible for increased rates of adverse drug reactions to clindamycin among patients with AIDS.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15703369&dopt=Abstract clindamycin antibiotic Cleocin-T