Cleocin
Compatibility of clindamycin phosphate with amikacin sulfate at room temperature and with gentamicin sulfate and tobramycin sulfate under frozen conditions.

Marble DA, Bosso JA, Townsend RJ.

The stability and compatibility of clindamycin phosphate with three aminoglycosides, amikacin sulfate, tobramycin sulfate, and gentamicin sulfate, admixed in either glass bottles or plastic bags, were studied under various storage conditions. In addition to the various two-drug combinations, each antibiotic was studied alone in the same solutions under the same storage conditions investigated for the various combinations. Clindamycin phosphate was admixed with amikacin sulfate in 100 ml glass bottles of both dextrose 5% in water (D5W) and NaCl 0.9%. The resultant solutions were examined for visual clarity; both pH and antibiotic concentrations were measured at the time of mixing and at 1, 4, 8, 12, 24, and 48 hours later. The solutions were maintained at room temperature under ambient lighting conditions throughout the observation period. Clindamycin phosphate was also admixed with tobramycin sulfate and gentamicin sulfate, in separate experiments, in 50 ml plastic bags of D5W and NaCl 0.9%. These solutions were examined, at the time of mixing, for visual clarity, pH, and antibiotic concentration and then frozen at -20 degrees C. They were thawed 14 and 28 days later and reexamined. Clindamycin phosphate concentrations were measured by high performance liquid chromatography; those of the aminoglycosides were determined by a fluorescence polarization immunoassay. A working definition of significant instability or incompatibility was defined as a greater than 10 percent loss of original antibiotic concentration. All single antibiotic solutions were stable throughout the observation periods.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3816545&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Autobac susceptibility testing of methicillin-resistant Staphylococcus aureus isolated in an Australian hospital.

Putland RA, Guinness MD.

Semiautomated rapid broth elution (Autobac Multi-Test System; General Diagnostics, Div. Warner-Lambert Co., Morris Plains, N.J.) and disk diffusion tests were compared with an agar dilution breakpoint method to determine the antibiotic susceptibility of 147 methicillin-resistant Staphylococcus aureus isolates from our hospital. Although the disk diffusion method, in general, correlated well with the agar dilution tests, the overall agreement of the Autobac tests with agar dilution tests was only 79%, with many very major discrepancies occurring with clindamycin (88%), gentamicin (33%), and methicillin (15%). When we used a 10-fold higher inoculum for the Autobac tests, all isolates were shown to be resistant to methicillin, but significant numbers of major and minor discrepancies occurred with chloramphenicol, fusidic acid, and neomycin. The majority of isolates were shown to belong to three biotypes, distinguishable by lactose fermentation, lipolysis, hemolysis, and pigment production. The antibiotic susceptibility profile of one biotype was found to be markedly different from those of the other biotypes and contained a high incidence of clindamycin susceptibility and neomycin, gentamicin, and kanamycin resistance. In contrast, the other two biotypes had a high incidence of clindamycin, gentamicin, and kanamycin resistance and neomycin susceptibility and accounted for most of the very major discrepancies in the clindamycin and aminoglycoside tests. In these methicillin-resistant S. aureus strains, discrepancies possibly may arise from partial expression of methicillin resistance, dissociated or inducible clindamycin resistance, and instability of gentamicin resistance.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3850902&dopt=Abstract clindamycin antibiotic Cleocin-T



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Stability of clindamycin phosphate and ceftizoxime sodium, cefoxitin sodium, cefamandole nafate, or cefazolin sodium in two intravenous solutions.

Bosso JA, Townsend RJ.

The stability and compatibility of clindamycin phosphate and ceftizoxime sodium, cefoxitin sodium, cefamandole nafate, or cefazolin sodium in two intravenous solutions were studied. Each antibiotic alone as well as each of the four two-drug combinations were examined when mixed in duplicate 100-mL glass bottles of 5% dextrose and 0.9% sodium chloride injections. Antibiotic concentration, pH, and visual appearance were recorded at the time of preparation and at 1, 4, 8, 12, 24, and 48 hours. Antibiotic concentrations were assessed with drug-specific high-performance liquid chromatographic assays. Decreases in concentration of 10% or more from the original concentration were considered to indicate instability. All the single antibiotic solutions were stable for 48 hours. Clindamycin was stable in all combinations except with ceftizoxime in 0.9% sodium chloride injection, which measured 89.3% of its original clindamycin concentration at 48 hours. All the cephalosporins mixed with clindamycin were stable for 48 hours. Clindamycin is stable for at least 48 hours when mixed with cefoxitin sodium, cefamandole nafate, or cefazolin sodium in either 5% dextrose or 0.9% sodium chloride injections and for at least 24 hours when mixed with ceftizoxime sodium in 0.9% sodium chloride injection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3864367&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Efficacy of clindamycin hydrochloride in refractory periodontitis. 12-month results.

Gordon J, Walker C, Lamster I, West T, Socransky S, Seiger M, Fasciano R.

The purpose of this study was to evaluate the use of clindamycin hydrochloride as an adjunct to conventional periodontal therapy in the treatment of patients who had previously been unsuccessfully treated with scaling, periodontal surgery and the use of tetracycline. Thirteen patients with a history of "refractory" periodontitis were thoroughly scaled and monitored by repeated attachment level measurements for the presence of active destructive periodontitis. Disease activity was defined as a 3-mm loss in attachment from baseline measurements or the occurrence of a periodontal abscess. When active disease was detected, each patient was scaled again and placed on clindamycin hydrochloride 150 mg qid for 7 days. Following the adjunctive use of clindamycin in combination with scaling, the incidence of gingival sites demonstrating active disease in the group of 13 patients decreased from an annual rate of 10.7 to 0.5%. Each patient demonstrated a decreased incidence of active sites per unit of time. Clinical parameters such as probing depth, gingival redness, bleeding on probing and suppuration showed dramatic improvement at 12 months after clindamycin therapy. The percentage of pockets with probing depths greater than 6 mm, 4 to 6 mm and 1 to 3 mm changed from 11 to 2%, 38 to 24% and 51 to 74% respectively, following clindamycin therapy as compared to scaling alone. The percentage of sites bleeding on probing decreased from 33% after scaling alone to 8% following clindamycin and scaling. Gingival redness decreased from 36 to 1% of sites. Suppuration also decreased from 8% of buccal or lingual surfaces after scaling alone to 1% of surfaces following scaling and clindamycin.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3908641&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
In vitro evaluation of clindamycin in combination with oxacillin, rifampin, or vancomycin against Staphylococcus aureus.

Ho JL, Klempner MS.

In a study of antibiotic combinations of clindamycin with rifampin, oxacillin, or vancomycin using the time kill-curve method, the combination of clindamycin and rifampin were sometimes synergistic (5 of 15 times), otherwise indifferent and always enhanced killing of fifteen tested Staphylococcus aureus isolates. In contrast, vancomycin and clindamycin or oxacillin and clindamycin were either indifferent or antagonistic (approximately 50%). Vancomycin alone, however, was generally as effective as the combinations of clindamycin and rifampin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3956136&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Six-year retrospective survey of the resistance of Bacteroides fragilis group species to clindamycin and cefoxitin.

Wexler HM, Harris B, Carter WT, Finegold SM.

Two hundred and forty-six strains of the Bacteroides fragilis group, all clinical isolates, collected at the Wadsworth Veterans Administration Medical Center from 1977 to 1982, were tested for susceptibility to clindamycin and cefoxitin. There was no significant change in resistance to either clindamycin or cefoxitin over the time period tested for any individual species, nor for the B. fragilis group in toto. Striking differences in susceptibility to the two drugs were seen among species of the B. fragilis group. B. fragilis displayed resistance to cefoxitin (32 micrograms/ml) and clindamycin (8 micrograms/ml) of 0.0% and 0.8%, respectively, whereas B. thetaiotaomicron showed resistances of 12.7% to cefoxitin (32 micrograms/ml) and 9% to clindamycin (8 micrograms/ml). B. thetaiotaomicron, B. distasonis, and B. ovatus are distinctly more resistant to cefoxitin than B. fragilis and B. vulgatus. Similarly B. thetaiotaomicron and B. distasonis are much more resistant to clindamycin than are the other B. fragilis group species. It is apparent that determination of species within the B. fragilis group is important in evaluating a potential therapeutic regimen.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3956142&dopt=Abstract clindamycin antibiotic Cleocin-T