Cleocin
Antibacterial effects of ofloxacin, clindamycin and sultamicillin on surgical removal of impacted third molars.

Goker K, Guvener O.

Department of Oral Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey.

This study examined the bacteraemia following surgical removal of impacted mandibular third molars and evaluated the antibacterial effects of Ofloxacin, Clindamycin, Sultamicillin, used as prophylactic medications. The study involved a hundred healthy patients whose mandibular third molars were impacted horizontally. These patients were divided into four groups each including 25 individuals. One of the four groups was the control group. The other groups were those to which Ofloxacin, Clindamycin, and Sultamicillin were administered one hour before the operation and in the following 4 days postoperatively. Blood samples were taken before and immediately after the operation, and then, 1 and 24 hours postoperatively. Following the incubation of the samples under aerobic and anaerobic conditions, the samples were examined microbiologically. Preoperative samples were found to be negative. In the immediate postoperative samples, bacteraemia was found in 44% of the control group, 40% of Ofloxacin and Clindamycin groups and 36% of the Sultamicillin group. In the samples taken 1 hour after the operation, bacteraemia was found in 28% of the control group, 20% of the Ofloxacin group and 24% of the Clindamycin and Sultamicillin groups. In the control group, only 2 cases showed positive culture in the blood samples taken 24 hours after the operation. In conclusion, the antibiotics, Ofloxacin, Clindamycin, Sultamicillin have a significant effect in decreasing the risk of postoperative infection and bacteraemia.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1308784&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Relationship between antibiotic concentration in bone and efficacy of treatment of staphylococcal osteomyelitis in rats: azithromycin compared with clindamycin and rifampin.

O'Reilly T, Kunz S, Sande E, Zak O, Sande MA, Tauber MG.

Pharma Research, Ciba-Geigy Ltd., Basel, Switzerland.

We examined the effect of azithromycin (CP-62,993), a new oral macrolide-like antibiotic, alone and in combination with rifampin, as treatment for experimental staphylococcal osteomyelitis. Clindamycin was used as a comparison drug. Rats (n = 10 to 15 per group) were infected by direct instillation of Staphylococcus aureus into the tibial medullary cavity. After 10 days, 21-day treatments with azithromycin (50 mg/kg of body weight, once daily, by the oral route), rifampin (20 mg/kg, once daily, subcutaneously), or clindamycin (90 mg/kg, three times daily, by the oral route) were started. The drugs were used singly or in combination (azithromycin plus rifampin or clindamycin plus rifampin). Peak azithromycin concentrations in bone were > 30 times higher than levels in serum, but the drug had little effect on final bacterial titers (5.13 +/- 0.46 log10 CFU/g of bone; for controls, 6.54 +/- 0.28 log10 CFU/g). Clindamycin was more active than azithromycin (3.26 +/- 2.14 log10 CFU/g of bone; 20% of sterilized bones), but rifampin was the most active single drug (1.5 +/- 1.92 log10 CFU/g; 53% of sterilized bones). Therapy with rifampin or clindamycin alone was associated with the emergence of resistance. Rifampin plus azithromycin (0.51 +/- 1.08 log10 CFU/g of bone; 80% of sterilized bones) and rifampin plus clindamycin (0.87 +/- 1.34 log10 CFU/g of bone; 66% of sterilized bones) were the most active regimens. Thus, azithromycin is ineffective as a single drug for the treatment of experimental staphylococcal osteomyelitis, despite high levels in bone that markedly exceeded the MIC, but it may be an attractive partner drug for rifampin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1336342&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Parasiticidal effect of clindamycin on Toxoplasma gondii grown in cultured cells and selection of a drug-resistant mutant.

Pfefferkorn ER, Nothnagel RF, Borotz SE.

Department of Microbiology, Dartmouth Medical School, Hanover, New Hampshire 03755-3842.

Clindamycin, which has been reported to have no significant in vitro activity against Toxoplasma gondii, actually markedly inhibits the growth of this parasite in infected human fibroblasts. When measured 3 days after treatment, the concentration required to reduce parasite growth by 50% is about 1 ng/ml. Some observers failed to note this inhibition because of its markedly delayed onset. At 6 ng/ml, clindamycin is parasiticidal, and the rate and extent of parasite killing increase with higher drug concentrations. With the aid of chemical mutagenesis, we isolated a parasite mutant that is approximately 100-fold more resistant to clindamycin than is the wild type. Lincomycin inhibits T. gondii at a higher 50% inhibitory concentration, about 100 ng/ml. The clindamycin-resistant mutant is partially cross-resistant to lincomycin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1510399&dopt=Abstract clindamycin antibiotic Cleocin-T



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In vitro and in vivo effects of clindamycin on polymorphonuclear leukocyte function.

Santos JI, Arbo A, Pavia N.

Department of Infectious and Parasitic Diseases, Hospital Infantil de Mexico, Federico Gomez, D.F.

The effects of clindamycin on polymorphonuclear leukocytes (PMNLs) were evaluated in vitro and in vivo in an experimental model and in immunocompromised patients with and without infection. Chemotaxis, chemiluminescence, and bactericidal capacity were evaluated using PMNLs preincubated with clindamycin in different concentrations. In the three phases of the study, clindamycin at a concentration of 2 mg/L significantly increased PMNL function. In contrast, when higher concentrations were used, PMNL function was not modified and in some cases it was decreased. Our findings suggest that clindamycin, in concentrations of 2 mg/L, positively modifies PMNL function.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1525792&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
[Clindamycin therapy of suspected toxoplasmosis retinochoroiditis]

[Article in German]

Mittelviefhaus H.

Universitats-Augenklinik Freiburg.

It is generally accepted that toxoplasmic retinochorioiditis should be treated when central visual function is threatened. Although controlled trials of treatment led to contradictory results, a combination of pyrimethamin, sulphadiazine and folinic acid is regarded to be the most effective treatment strategy. Nevertheless, hematological complications necessitate a discontinuation of these drugs in up to 1/4 of the patients. Clindamycin, a semisynthetic antibiotic, also has an antitoxoplasmal effect on animals and is less toxic to the bone marrow. A theoretical advantage is that Clindamycin can penetrate and act on the encysted form of the parasite and that it will accumulate in the uveal tissue of the eye. Between 1983 and 1991 we performed 102 courses of treatment in 90 patients with presumed toxoplasmic retinochorioiditis. 900-1800 mg Clindamycin were given in combination with 60-80 mg Fluorcortolon which was gradually decreased during a 4 to 6 week period. In general Clindamycin was given for 6 weeks. Duration varied from 4 to 12 weeks. 15 patients experienced side effects of treatment. 6 of them complained of diarrhea and gastrointestinal bleeding and 7 patients developed allergic exanthem and acne. Mild lymphopenia and hepatotoxicity were further complications. In 8 patients the drugs had to be discontinued; 4 times for gastrointestinal discomfort, 3 times for allergic exanthem and in one patient for mild hepatotoxicity. We did not observe any serious complications during therapy. Only 9 complications were attributable to clindamycin, they disappeared immediately after discontinuing treatment.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1533697&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Ex vivo protein binding of clindamycin in sera with normal and elevated alpha 1-acid glycoprotein concentrations.

Kays MB, White RL, Gatti G, Gambertoglio JG.

College of Pharmacy, Medical University of South Carolina, Charleston 29425-0810.

Clindamycin is a lincosamide antibiotic that binds primarily to alpha 1-acid glycoprotein (AAG), an acute-phase serum protein. Many studies have shown that AAG concentrations increase in response to stress, including infection, myocardial infarction, and trauma. The objectives of this study were to determine the serum protein binding of various clindamycin concentrations in sera with normal and elevated AAG concentrations. Serum was obtained from 4 healthy volunteers and 12 patients with pathophysiologic conditions known to elevate serum AAG concentrations. Timing for collection was determined from the literature, corresponding with the expected peak concentration for each disease state. Samples were assayed for AAG by radial immunodiffusion and were spiked with clindamycin to achieve total concentrations of 10 micrograms/ml (n = 18), 4 micrograms/ml (n = 10), and 2 micrograms/ml (n = 7). Protein binding was determined by ultrafiltration and subsequent high-performance liquid or gas chromatography. Protein binding was dependent on the serum concentrations of both AAG and clindamycin. When AAG concentrations increased from 101-150 mg/dl to 201 mg/dl or greater, mean protein binding increased from 81.2% to 92.4% (p = 0.1265) and from 61.3% to 88.6% (p less than 0.05) at clindamycin concentrations of 2 and 4 micrograms/ml, respectively. With AAG concentrations between 101 and 150 mg/dl, mean protein binding increased from 62.4% at 10 micrograms/ml to 81.2% at 2 micrograms/ml (p = 0.1514). Since AAG concentrations may increase in certain patients, the concentration of free (pharmacologically active) drug may fall below the minimum inhibitory concentration for several pathogens earlier in a dosing interval.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1549539&dopt=Abstract clindamycin antibiotic Cleocin-T