Home Drug Guide Clindamycin Phosphate

Drug Guide

Generic Name

Clindamycin Phosphate

Brand Names Cleocin Phosphate, Cleocin T, Cleocin, Clindamycin Phosphate In Dextrose 5%, Cleocin Phosphate In Dextrose 5% In Plastic Container, Clindagel, Clindesse, Evoclin, Clinda-derm, Clindets, Clindamycin Phosphate In 5% Dextrose In Plastic Container, Clindamycin Phosphate In 0.9% Sodium Chloride, Xaciato

Classification

Therapeutic: Antibacterial, anti-infective

Pharmacological: Lincosamide antibiotic

FDA Approved Indications

  • Treatment of bacterial infections caused by susceptible organisms, including skin and soft tissue infections, respiratory tract infections, intra-abdominal infections, septicemia, and gynecologic infections.
  • Vaginal bacterial infections (Clindesse).
  • Acne (Clindagel, Evoclin).
  • Prevention of Group B streptococcal disease in pregnant women with colonization.

Mechanism of Action

Clindamycin binds to the 50S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis, which leads to inhibition of bacterial growth.

Dosage and Administration

Adult: Varies based on formulation and infection type; typically, oral doses of 150-450 mg every 6-8 hours.

Pediatric: Doses vary; usually 8-13 mg/kg/day divided into 3-4 doses, depending on infection severity.

Geriatric: Adjustments based on renal and hepatic function; no specific change if renal/hepatic functions are normal.

Renal Impairment: Use cautiously; consider dose adjustments due to potential accumulation.

Hepatic Impairment: Use with caution; may require dose adjustments.

Pharmacokinetics

Absorption: Well absorbed from oral and IM routes.

Distribution: Widely distributed: can penetrate tissues and body fluids, including bone and abscesses.

Metabolism: Metabolized in the liver via CYP3A4.

Excretion: Excreted mainly in the bile; small amount via kidneys.

Half Life: Approx. 2.4 hours for systemic forms.

Contraindications

  • History of hypersensitivity to clindamycin or other lincosamides.
  • History of antibiotic-associated colitis.

Precautions

  • Use with caution in patients with compromised hepatic function; monitor for secondary infections; potential for pseudomembranous colitis.

Adverse Reactions - Common

  • Diarrhea (Common)
  • Nausea (Common)
  • Skin rash (Less common)

Adverse Reactions - Serious

  • Clostridioides difficile-associated diarrhea (Serious, can be life-threatening)
  • Anaphylaxis (Rare)
  • Hepatotoxicity (Rare)
  • Colitis (including pseudomembranous colitis) (Serious)

Drug-Drug Interactions

  • Erythromycin and other macrolides (can antagonize binding).
  • Neuromuscular blocking agents (may enhance neuromuscular blockade).

Drug-Food Interactions

  • Use caution with alcohol, may increase gastrointestinal irritation.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of superinfection, diarrhea, liver function tests.

Diagnoses:

  • Risk for secondary infection
  • Impaired skin integrity

Implementation: Administer as prescribed; monitor for adverse effects and response; educate patient on signs of infection and adverse effects.

Evaluation: Effectiveness in resolving infection; absence of adverse reactions.

Patient/Family Teaching

  • Complete full course of therapy.
  • Report diarrhea, rash, or any signs of allergic reaction.
  • Use cautiously with other medications; inform healthcare provider of all current medications.

Special Considerations

Black Box Warnings:

  • Colitis associated with broad-spectrum antibiotic use, including pseudomembranous colitis.
  • Risk of Clostridioides difficile-associated diarrhea.

Genetic Factors: No significant genetic factors identified.

Lab Test Interference: May cause false-positive ESR or AST tests.

Overdose Management

Signs/Symptoms: Diarrhea, colitis, hypersensitivity reactions.

Treatment: Supportive care, discontinue drug, consider use of probiotics or specific therapies for complications.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable as per manufacturer's specifications.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.