Cleocin
The combination formulation of clindamycin 1% plus benzoyl peroxide 5% versus 3 different formulations of topical clindamycin alone in the reduction of Propionibacterium acnes. An in vivo comparative study.

Leyden J, Kaidbey K, Levy SF.

Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

BACKGROUND: Isolates of Propionibacterium acnes resistant to one or more anti-acne antibiotics (most commonly erythromycin) are being increasingly reported, and the emergence of resistant strains can be associated with therapeutic failure of topical treatment. OBJECTIVE: Comparison of the in vivo effectiveness of the combination of clindamycin 1% plus benzoyl peroxide 5% in a gel formulation to that of each of 3 clindamycin 1% preparations (gel, lotion, and solution) with respect to reduction in counts of P. acnes cultured from the foreheads of healthy volunteers. METHODS: The effects of treatment with the 4 study drugs were compared in an open-label study. Cultures were collected before, after 1 week and after 2 weeks of treatment. RESULTS: Treatment with the combination formulation resulted in a 99.8% (> 2 logs) reduction in total propionibacterial numbers after 1 week of therapy compared with 30 to 62% (< 1 log) decreases for the different formulations of topical clindamycin alone. By the end of week 2, the combination had decreased P. acnes counts by more than 99.9% (> 3 logs) relative to reductions of from 88 to 95% (< or > 1 log) for the single agent formulations. CONCLUSIONS: Under the conditions of the present study, the combination of clindamycin 1% plus benzoyl peroxide 5% gel produced more rapid and highly significant reductions in P. acnes compared with formulations containing clindamycin alone.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11705253&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
[Effect of clindamycin on stimulation of cell adhesion molecules by endotoxins and enterotoxin of Bacteroides fragilis strains]

[Article in Polish]

Meisel-Mikolajczyk F, Rokosz A, Kot K, Zawidzka E, Malchar C, Nowaczyk M, Gorski A.

Katedra i Zaklad Mikrobiologii Lekarskiej AM w Warszawie.

The influence of clindamycin on expression of B. fragilis endotoxins (LPS) and enterotoxin stimulated cell adhesion molecules: ICAM-1, VCAM-1 and E-selectin on HMEC-1 (human microvascular endothelial cell line) was tested. Lipopolysaccharides from four Bacteroides fragilis strains: one nonenterotoxigenic (NTBF) and three enterotoxigenic (ETBF) were extracted by hot phenol-water method and purified. B. fragilis enterotoxin was prepared according to the method described by van Tassel et al. (1992). All bacterial preparations were used for stimulation at concentration 10 micrograms/ml. Clindamycin was used in concentration of 2 micrograms/ml. The influence of antimicrobial agent on the endotoxins and enterotoxin stimulation and expression of adhesion molecules was tested by ELISA, using monoclonal mouse anti-human antibodies (Genzyme, USA). Peroxidase-conjugated rabbit anti-mouse immunoglobulins (DAKO A/S Denmark) and OPD (Sigma USA) were used. The coloured reaction product was measured by reading the absorbance at 492 nm in SPECTRA II reader (SLT, Austria). It was observed that clindamycin influenced the expression of cell adhesion molecules on resting cell line. HMEC-1 cells stimulated with Bacteroides fragilis LPS preparations have suppressive effect on ICAM-1 expression. ICAM-1 expression was augmented when stimulated with Tox 1 and Tox 2 preparations. Clindamycin augmented the VCAM-1 expression in tests with all bacterial preparations. All used bacterial preparations of Bacteroides fragilis LPS and enterotoxin enhanced the expression of E-selectin with exception of LPS of NTBF strain.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11757424&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
[Detection of ermB gene responsible for high level resistance to clindamycin (MLS type resistance) among Clostridium difficile strains isolated from antibiotic associated diarrhea (AAD)]

[Article in Polish]

Pituch H, Obuch-Woszczatynski P, Meisel-Mikolajczyk F, Luczak M.

Katedra i Zaklad Mikrobiologii Lekarskiej AM w Warszawie.

In 68 C. difficile strains isolated from feacal samples of patients with antibiotic associated diarrhoea (AAD) investigated presence of ermB gene transferable of high level resistance to clindamycin. The primers set 2980/2981 used for identification of ermB gene amplified a 688 bp segment. We used the Etest to assess all strains for susceptibility to clindamycin. This study demonstrates that 57% of strains isolated from faecal samples of patients with AAD were highly resistant to clindamycin (minimal inhibitory concentration (MIC) of clindamycin, 256 mg/L) and possessed the ermB gene.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12908416&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Prophylactic efficacy of recombinant IL-12, clindamycin alone or in combination against experimental reactivated toxoplasmosis.

Tawfeek GM, Oteifa NM, Mustafa MA.

Department of Parasitology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Reactivation of experimental chronic toxoplasmosis was induced by daily i.m. injection of 0.1 ml hydrocortisone acetate (25 mg/ml) per mouse. Administration of clindamycin (5 mg/kg orally), rIL-12 (0.25 microg i.p.) or combination of both was done once weekly for 3 months course starting 2 days post suppression. The prophylactic effect was assessed by determination of both survival rate and brain cyst counts with histopathological examination of brain sections at different time points post suppression besides the influence of these drug regimens on interferon gamma (IFN-delta) production. All immunocompromised untreated mice exhibited increased brain cyst burdens and reduced IFN-delta production and died due to toxoplasmic encephalitis. Neither clindamycin nor rIL-12 prevented reactivation of chronic infection, however, the slight prolongation of survival was observed. Simultaneous administration of clindamycin and rIL-12 resulted in prevention of reactivation in 73.3% of the mice till the end of the experiment. The combination regimen produced significant higher levels of IFN-delta than either drug alone suggesting that both rIL-12 and clindamycin can act additively or synergistically to prevent reactivation of chronic infection with T. gondii most probably through enhancement of IFN-delta production.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11775111&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Effect of clindamycin in a model of acute murine toxoplasmosis.

Vukovic D, Djurkovic-Djakovic O, Kovacevic S, Bobic B, Nikolic A, Todorovic V V, Babic D.

Toxoplasmosis Research Laboratory, Institute for Medical Research.

OBJECTIVE: To characterize the antitoxoplasma activity of clindamycin in a murine model of acute toxoplasmosis. METHODS: Rates of survival and mean survival times of Swiss Webster mice infected intraperitoneally with 106-102 tachyzoites of the RH strain of Toxoplasma gondii treated with clindamycin or sulfamethoxazole (positive control) or untreated (negative control) were compared. Survivors were submitted to examination of untreated brain tissue preparations, intraperitoneal and peroral subinoculations of brain tissue homogenates into fresh mice, and to pathohistology, including immunohistochemistry, of brain and lungs. RESULTS: The effect of clindamycin treatment (400 mg/kg/day) on infected Swiss Webster mice was inoculum size dependent, ranging from no survivals in animals infected with 106 parasites, to 100% survivals with an inoculum of 102. Treatment initiated 24 h before and at time of infection prolonged mean survival times comparably to sulfamethoxazole, and significantly when compared to untreated controls. In contrast, treatment initiated 48 h postinfection with an inoculum of 106 did not postpone death. In the clindamycin-treated survivors, there was no biological or histologic evidence for the persistence of toxoplasma. CONCLUSIONS: The results obtained show that at an appropriate parasite dose/drug dose ratio, clindamycin is strongly toxoplasmacidal in a murine model of acute toxoplasmosis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11864081&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Oral supplementation with lactic acid-producing bacteria during intake of clindamycin.

Nord CE, Lidbeck A, Orrhage K, Sjostedt S.

Departments of Microbiology and.

OBJECTIVE: To study the effect of administration of clindamycin with or without supplementation of the intestinal microflora with Bifidobacterium bifidum and Lactobacillus acidophilus. METHODS: Twenty-three healthy subjects received clindamycin by mouth for 7 days. Eleven of the subjects also received capsules containing lyophilized L. acidophilus and B. bifidum for 14 days. The other 12 subjects received placebo. RESULTS: There was a marked decrease in total numbers of anaerobic bacteria during the administration of clindamycin. In the lactic acid bacteria-supplemented group, a tendency towards delayed reduction and earlier increase in bifidobacteria was observed, and two of 11 subjects (18%) were colonized with Clostridium difficile, in comparison with five of 12 (41%) in the placebo group. The total number of microorganisms was significantly higher in the lactic acid bacteria-supplemented group than in the placebo group (p=0.02) 4 days after the end of clindamycin administration. The difference was mainly due to higher counts of Escherichia coli and enterococci. Mean levels of other enterobacteria increased less in the lactic acid bacteria-supplemented group than in the placebo group between days 0 and 14. CONCLUSIONS: The recolonization with aerobic and anaerobic microorganisms was faster in the lactic acid bacteria-supplemented group than in the placebo group. This may be of importance in preventing colonization with C. difficile.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11864087&dopt=Abstract clindamycin antibiotic Cleocin-T