Cleocin
Streptococcus bovis revisited: a clinical review of 81 bacteremic episodes paying special attention to emerging antibiotic resistance.

Siegman-Igra Y, Schwartz D.

Infectious Diseases Unit, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ZIHUM tasmc.health.gov.il

Following 2 Cases of Streprococcus bovis endocarditis with a high level of resistance to clindamycin during 2002, the authors reviewed their clinical experience with S. bovis bacteremia during 2 periods, starting in 1980. 81 episodes of S. bovis bacteremia represented approximately 1% of all episodes of bacteremia. In 32 (40%) cases the bacteremia represented endocarditis, in 15 (19%) the bacteremia originated from sick bowel, 11 (14%) were suspected to arise from urinary tract infection, 10 (12%) originated from biliary or peritoneal infection, and 13 from other or unknown sources. 25 (31%) of the bacteremias were polymicrobial. All of the isolates were highly susceptible to penicillin and clindamycin, with the following exceptions: 2 isolates had a minimal inhibitory concentration (MIC) of 0.5 mg/l to penicillin (in 1997) and 5 isolates had an MIC of > 2 mg/l to clindamycin (in 1997, 1998, 2000 and 2002). The 2 most recent of these 5 had high-level resistance to clindamycin of > 256 mg/l. It seems that clindamycin resistance in S. bovis is an emerging phenomenon, in contrast to penicillin resistance, high levels of which have not yet been described in S. bovis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12693556&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Concentrations of clindamycin in the mandibular bone of companion animals.

Zetner K, Schmidt H, Pfeiffer S.

University of Veterinary Medicine, Clinic of Surgery and Ophthalmology, Veterinarplatz 1, 1210 Wein, Austria.

Concentrations of clindamycin in the mandible were determined in 17 dogs and 13 cats with severe plaque, gingivitis/periodontitis, and calculus that were treated orally with clindamycin (11 mg/kg) once daily for 5 days prior to professional teeth cleaning and extractions. The animals were patients at the Dental Department of the Clinic for Surgery and Ophthalmology of the University of Veterinary Medicine in Vienna, Austria. Clindamycin levels were determined during postextractional alveoloplasty. Approximately 1 to 3 mm3 of mandible was removed from the intraradicular septum in multirooted teeth and from the protruding labial/buccal alveolar rim with a small rongeur. The mean concentration of clindamycin was 8.18 microg/g in dogs (range=3.16 to 24.08 microg/g) and 17.43 microg/g in cats (range=2.45 to 51.60 microg/g). The concentration of clindamycin in the mandibles of dogs and cats may be useful to combat infections after periodontal procedures, tooth extractions, or injuries to the mandible.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14506592&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
[Susceptibility of Streptococcus pyogenes to macrolides and quinolones in Guadalajara, Spain]

[Article in Spanish]

Rodriguez-Zurita ME, Solis del Bano S, Robres Guillen P, Gonzalez Praetorius A, Gimeno Fernandez C, Perez Pomata MT, Bisquert Santiago J.

Seccion de Microbiologia, Hospital General Universitario de Guadalajara, C/ Donantes de Sangre s/n, Guadalajara, Spain.

We carried out a retrospective study of the susceptibility of 104 Streptococcus pyogenes strains, which were isolated in 2000 and 2001 from clinical samples of different origins, to penicillin, erythromycin, clindamycin, ofloxacin and levofloxacin. The susceptibility testing was performed using the agar difusion method according to the guidelines of the NCCLS. All of the isolates showed susceptibility to penicillin and clindamycin. However, we detected 11 strains that were resistant to erythromycin (10.6%) and 4 strains resistant to ofloxacin (3.8%). We studied the resistance phenotypes of macrolides and lincosamides using erythromycin and clindamycin discs. Nine of the eleven strains that were resistant to erythromycin showed an M phenotype, while the remaining two showed inducible resistance to clindamycin, thus suggesting an MLS(B) inducible phenotype. No strains with constitutive resistance to erythromycin or clindamycin (MLS(B) constitutive phenotype) were identified. While penicillin is still uniformly active against S. pyogenes, in Guadalajara, there are 10.6% strains that are resistant to 14- and 15-atoms macrolides.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12750759&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Antibiotics and light responses in superfused bovine retina.

Walter P, Luke C, Sickel W.

Department of Ophthalmology, University of Cologne, Germany.

1. Our objective was to study effects of clindamycin and ciprofloxacin on the electroretinogram (ERG) of isolated bovine retinas. 2. Electroretinograms of isolated superfused bovine retinas were recorded under normal conditions and during application of clindamycin and ciprofloxacin. The b-wave reduction was plotted against the drug concentration. In several cases retinal oxygen uptake was also measured. Clindamycin was available only in a preparation containing benzyl alcohol. To differentiate between effects caused by the antibiotic and the alcohol, ERGs were also recorded under superfusion with benzyl alcohol. To record drug effects on photoreceptors synaptic transmission was blocked using 1 mM aspartate. 3. At concentrations between 0.3 and 10 mM clindamycin significantly reduced the amplitude of the b-wave of the ERG. A comparable reduction of retinal oxygen uptake was found at concentrations 10-fold higher. Clindamycin, 3 mM, did not affect the a-wave after preincubation with aspartate. Benzyl alcohol at concentrations of 0.3 and 1 mM did not affect the b-wave, whereas at higher concentrations the b-wave was found to be reduced. Considerable b-wave reductions were found with ciprofloxacin at concentrations of between 0.03 and 0.6 mM. All effects proved to be fully reversible and dose-dependent. 4. Ciprofloxacin and clindamycin did both alter neural function in the isolated superfused bovine retina. The nontoxic dosages found here differ considerably from results in rabbits after intravitreal injections. This is probably due to species differences.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10079968&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Treatment of intra-abdominal infections: cost comparison of ampicillin/sulbactam and clindamycin/gentamicin.

Chin A, Gill MA, Ito MK, Yellin AE, Berne TV, Heseltine PN, Appleman MD.

School of Pharmacy, University of Southern California, Los Angeles.

The cost of 2 g ampicillin/1 g sulbactam given IV piggyback qid was compared with 900 mg clindamycin admixed with 1.5 mg/kg gentamicin given IV piggyback tid for the treatment of perforated or gangrenous appendicitis in 116 patients. Fifty-eight ampicillin/sulbactam-receiving patients incurred greater costs for IV supplies (+104.6/patient vs +67.9/patient) and nursing administration costs (+16.5/patient vs +10.7/patient). On the other hand, pharmacist and technician preparation costs were greater for the 58 clindamycin/gentamicin-receiving patients (+15.4/patient vs +13.3/patient). The clindamycin/gentamicin-receiving patients also incurred additional changes for laboratory fees and pharmacokinetic monitoring--+18.7/patient and +36.1/patient, respectively. When incorporating all cost parameters, there were no statistically significant differences in mean total drug therapy costs between the two treatment regimens--+433.3 +/- +58.5/patient for ampicillin/sulbactam and +373.8 +/- +86.2/patient for clindamycin/gentamicin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10103837&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Impact of a target drug monitoring program on the usage of clindamycin.

Gin AS, Lipinski LA, Honcharik N.

Health Sciences Centre, Winnipeg, Manitoba.

The use of parenteral clindamycin at the Health Sciences Centre had not been amendable to traditional cost containment strategies. Clindamycin was targeted through a Target Drug Monitoring (TDM) Program to improve its appropriate use. A retrospective audit was conducted to serve as a baseline. In the concurrent phase, the TDM pharmacist reviewed and assessed clindamycin cases based on approved criteria. Those cases which failed to meet the criteria were targeted in order to convert clindamycin to alternative agents. The concurrent TDM program reviewed 339 cases of clindamycin over a 32-week period, of which 76 cases (22.4%) failed to meet the criteria and were targeted. Of the 76 recommendations, 48 (63.2%) were accepted. Cost-avoidance due to direct intervention was approximately $16,000 annualized compared to $28,000 estimated from the retrospective audit. Fiscal year-end antibiotic usage indicated a dramatic decline (32%) in clindamycin use. Net savings of $37,600 were attributed to modification of physician prescribing. The TDM program was successful in identifying areas of inappropriate clindamycin use and correcting them by direct interaction with the prescriber(s).

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10134127&dopt=Abstract clindamycin antibiotic Cleocin-T