Cleocin
Tissue concentrations of clindamycin after multiple oral doses in normal cats.

Brown SA, Zaya MJ, Dieringer TM, Hunter RP, Nappier JL, Hoffman GA, Hornish RE, Yein FS.

Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine, Texas A&M University, College Station 77843.

Eighteen normal cats were randomly allocated into two blocks with three treatment groups and dosed orally with clindamycin aqueous solution for 10 days at a dosage rate of 5.5 mg/kg twice daily (Group 1), 11 mg/kg twice daily (Group 2), or 22 mg/kg once daily (Group 3). At the end of dosing, all cats were killed and tissues were taken for clindamycin concentration analysis. Clindamycin was extracted from tissues using solid-phase extraction columns followed by microbiological assay of clindamycin using a cylinder plate assay using M. luteus. Recovery from each tissue was determined by inoculating known concentrations of clindamycin into drug-naive tissues and comparing the observed concentration from the expected concentration. Confirmation that the bioassay detected clindamycin and not N-desmethylclindamycin, its active metabolite, was done using gas-chromatography-mass-spectrometry. Concentrations were highest in the lung, with tissue:serum ratios greater than 3 in all groups. Concentrations were higher in Group 3 than Group 1 (P less than 0.05). Only liver concentrations in Group 3 were statistically higher than in Group 2, although all tissues except bone marrow and CSF had numerically higher concentrations in Group 3 than Group 2. The tissue:serum ratio was greater than 1 in all tissues studied except bone, cerebrospinal fluid, brain, and skeletal muscle.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2231867&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Efficacy of clindamycin hydrochloride in refractory periodontitis: 24-month results.

Gordon J, Walker C, Hovliaras C, Socransky S.

Department of Periodontology, Fairleigh Dickinson, Jr., College of Dental Medicine, Hackensack, NJ.

The purpose of this investigation was to evaluate the use of clindamycin hydrochloride in the treatment of adult refractory periodontitis. Thirty patients with a history of unsuccessful treatment with scaling, periodontal surgery, and the use of tetracyclines were entered into the study. Upon entry, the suspected refractory patients were scaled several times and then monitored for the presence of active disease by probing attachment level measurements performed in duplicate. Active disease was defined as a 3.0 mm or greater loss in attachment from the baseline examination or the occurrence of a periodontal abscess. When active disease was detected, patients were treated with scaling and clindamycin 150 mg qid for 7 days. Patients served as their own controls. Twenty four patients demonstrated further attachment loss following scaling alone and were treated with clindamycin hydrochloride. Scaling and clindamycin treatment decreased the incidence of active disease from an annual rate of 8.0% to 0.5% of sites per patient (P less than .001). The mean time required to detect the first active site increased from 4.9 +/- 3.7 months following scaling alone to 16.7 +/- 7.6 months following scaling and clindamycin (P less than 001). Active sites lost an average of 3.1 mm of probing attachment following scaling alone but "gained" back 2.0 mm at 6 months and 1.5 mm at 24 months post-antibiotic and scaling treatment. Bleeding on probing was significantly reduced (P less than .05) from 31.8% of sites pre-clindamycin treatment to 12.3% at 12 months and 17.9% of sites at 24 months post-clindamycin treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2254835&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
The effect of clindamycin on the microbiota associated with refractory periodontitis.

Walker C, Gordon J.

Department of Oral Biology, University of Florida, Gainesville.

The purpose of this investigation was to determine the effect of clindamycin hydrochloride, as an adjunct to scaling, on the microbiota associated with refractory periodontitis and to elucidate the probable causative bacteria associated with the disease. Microbial samples were collected from a subset of 9 patients with severe adult periodontitis who had not responded to conventional treatment modalities including the use of tetracycline and other antibiotics. Microbial samples were collected from a relatively deep site determined to be actively losing attachment and a comparably deep, but quiescent, control site in each patient prior to clindamycin therapy. Samples continued to be collected from the same sites for up to 1 year post-therapy. The microbial flora of each sample were enumerated by darkfield microscopy and predominant cultivable methods. Prior to clindamycin therapy, both active and control sites consisted on average of approximately 50% spirochetes and motile rods and 40% Gram-negative anaerobic rods. Bacteroides intermedius and Porphyromonas gingivalis (formerly B. gingivalis) were elevated in the active, as compared to control, sites and accounted for approximately 20% of the cultured microbiota in the former. Following treatment with clindamycin, the Gram-negative components of the microbiota were either eliminated or severely suppressed. At 1 year post-therapy, spirochetes and motile rods together accounted for about 15% of the microscopic flora. Total Gram-negative anaerobic rods accounted for approximately 20%, and B. intermedius and P. gingivalis combined accounted for less than 2% of the cultured microbiota from historical active sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2254836&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Systemic absorption of clindamycin following intravaginal application of clindamycin phosphate 1% cream.

Borin MT.

Clinical Pharmacokinetics Unit, Upjohn Company, Kalamazoo, Michigan 49001.

The extent to which clindamycin is absorbed systemically following intravaginal application of clindamycin phosphate 1% cream was assessed in 12 healthy female volunteers. Each subject received a single intravenous dose of clindamycin phosphate sterile solution (48 mg). A week later, each subject received 50 mg (5 mL) doses of intravaginal cream according to one of two dosage regimens: once daily (qd) for seven consecutive doses or twice daily (q12hr) for 13 consecutive doses. Steady state was achieved on or before day 4 for both regimens. The absolute bioavailabilities of the two intravaginal treatments were 6% for qd dosing and 13% for q12hr dosing, indicating that only a small fraction of the intravaginal dose is absorbed systemically.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2303578&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Increasing antibiotic resistance of streptococcus species in New York City.

Lin K, Tierno PM Jr, Komisar A.

Department of Otolaryngology, New York University Medical Center, New York, NY, USA.

OBJECTIVE: Streptococcus species are common pathogens in head and neck infections and are leading causes of morbidity and mortality. Emerging penicillin-resistant streptococcal pathogens have shifted empirical antibiotic therapy in favor of valuable alternatives, including erythromycin and clindamycin. This study was undertaken to determine the magnitude of antimicrobial resistance to these antibiotics. STUDY DESIGN: Retrospective review. METHODS: A retrospective study of two streptococcal species isolates, Streptococcus pyogenes (163 specimens) and Streptococcus pneumoniae (164 specimens), collected between January 1, 2001 and January 1, 2002 at two academic institutions. The antibiotic susceptibility patterns were analyzed for penicillin, erythromycin, and clindamycin according to the National Committee for Clinical Laboratory Standards. RESULTS: Fourteen percent to 34% of S. pyogenes isolates were erythromycin-resistant, and 0% to 28% were clindamycin-resistant. None of the S. pyogenes isolates were resistant to penicillin. Of the S. pneumoniae isolates, 33% to 50% were resistant to erythromycin, and 18% to 33% were resistant to clindamycin. The penicillin resistance levels for S. pneumoniae were 0% to 45%. CONCLUSIONS: Our antimicrobial resistance levels for S. pyogenes and S. pneumoniae significantly exceeded national and worldwide levels of erythromycin and clindamycin resistance. With a diverse population of over 8 million residents and high physician supply, our model is a microcosm for the study of antimicrobial use and susceptibility patterns and of clinical failure.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15235338&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Clindamycin effect on glycocalyx production in experimental viridans streptococcal endocarditis.

Dall L, Keilhofner M, Herndon B, Barnes W, Lane J.

Department of Medicine, University of Missouri-Kansas City, School of Medicine 64108.

Abundant glycocalyx production by viridans streptococci in the rabbit model of endocarditis has been associated with delayed antimicrobial sterilization. Enzymatic digestion of the glycocalyx with dextranase enhances antibiotic activity. The effect of clindamycin (30 mg/kg, subcutaneous, three times daily) was studied in rabbits with experimental aortic valve endocarditis caused by high glycocalyx-producing viridans streptococci. Animals receiving clindamycin had smaller vegetations that were sterilized more quickly than did controls or animals receiving penicillin or dextranase alone (P less than .001). Penicillin plus dextranase treatment allowed greater bacterial killing than penicillin alone and did not differ significantly from clindamycin treatment. Electron micrographs revealed markedly less cell-adherent glycocalyx on organisms grown in vitro treated with clindamycin versus penicillin and controls. It is hypothesized that clindamycin inhibits glycocalyx production in vivo, allowing better antimicrobial penetration in the infected cardiac vegetation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2345303&dopt=Abstract clindamycin antibiotic Cleocin-T