Cleocin
Effects of clindamycin on derepression of beta-lactamases in gram-negative bacteria.

Sanders CC, Sanders WE Jr, Goering RV.

Depression of beta-lactamases in certain non-fastidious Gram-negative bacilli has been responsible for (i) the rapid development of resistance to a variety of beta-lactam antibiotics and (ii) antagonism between beta-lactam antibiotics. Therefore, the effects of a variety of inhibitors of macro-molecular synthesis on derepression of beta-lactamase were investigated with four strains each of enterobacter and Pseudomonas aeruginosa. When tested at concentrations that were not inhibitory to growth, clindamycin was the most effective inhibitor of derepression of beta-lactamases in some of the strains examined. In one enterobacter isolate, clindamycin completely prevented derepression of beta-lactamases. This effect was highly specific as clindamycin did not influence constitutive beta-lactamase or depression of other inducible enzymes in this same strain. These results suggest that clindamycin may selectively inhibit synthesis of beta-lactamase under repressor control in some bacteria without affecting synthesis of other proteins or replication. Such selective inhibition may provide a new approach for the enhancement of the antibacterial activity of certain beta-lactam antibiotics.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6417103&dopt=Abstract clindamycin antibiotic Cleocin-T



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Inhibition of jejunal water and electrolyte absorption by therapeutic doses of clindamycin in man.

Spiller RC, Higgins BE, Frost PG, Silk DB.

A steady-state perfusion technique has been used in vivo in normal subjects to show that at concentrations occurring during therapeutic use (500 mg/1, 1.1 mmol/l) the antibiotic clindamycin reversibly inhibits bicarbonate-stimulated water and electrolyte absorption from the human jejunum. Lactose-stimulated water and electrolyte absorption was not affected by the addition of clindamycin at the same concentration. Clindamycin-induced malabsorption of water and electrolytes may contribute significantly to the diarrhoea that occurs during clindamycin therapy in the absence of pseudomembranous colitis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6428796&dopt=Abstract clindamycin antibiotic Cleocin-T



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Community-based surveillance in the united states of macrolide-resistant pediatric pharyngeal group A streptococci during 3 respiratory disease seasons.

Tanz RR, Shulman ST, Shortridge VD, Kabat W, Kabat K, Cederlund E, Rippe J, Beyer J, Doktor S, Beall BW; North American Streptococcal Pharyngitis Surveillance Group.

Division of General Academic Pediatrics, Children's Memorial Hospital, Chicago, IL 60614, USA. rtanz northwestern.edu

BACKGROUND: In 2001, a total of 48% of pharyngeal group A streptococci (GAS) from Pittsburgh children were macrolide resistant. We assessed macrolide resistance, resistance genes, and emm types among GAS in the United States. METHODS: In prospective, multicenter, community-based surveillance of pharyngeal GAS recovered from children 3-18 years old during 3 respiratory seasons (the 2000-2001 season, the 2001-2002 season, and the 2002-2003 season), GAS were tested for macrolide resistance and underwent emm gene sequencing. Macrolide-resistant GAS were tested for resistance to clindamycin, and resistance genes were determined. RESULTS: Erythromycin resistance was observed in 4.4% of isolates from the 2000-2001 season, 4.3% from the 2001-2002 season, and 3.8% from the 2002-2003 season (P=.80). Clindamycin resistance was found in 1.04% of isolates; annual rates of clindamycin resistance were stable (P=.75). The predominant resistance genotype each year was mef A (65%-76.9%; overall, 70.3%). Resistant isolates included strains representing 8-11 different emm types each year. Heterogeneity of emm subtypes, resistance genes, and clindamycin resistance was evident among resistant isolates within some emm types. Geographic variability in resistance rates was present each year. CONCLUSIONS: The macrolide resistance rate among pharyngeal GAS was <5% and was stable over the 3 seasons. However, rates varied among sites each year. There was no evidence of spread of a specific resistant clone, increasing clindamycin resistance, or escalation in median erythromycin MICs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15578402&dopt=Abstract clindamycin antibiotic Cleocin-T



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[Antibacterial activity of clindamycin and lincomycin in broth, serum, and in combination with polymorphonuclear leukocytes against Staphylococcus aureus and Staphylococcus epidermidis]

[Article in German]

Bassler M, Just HM, Richter A, Zeller H, Daschner F.

We investigated the antibacterial activity of clindamycin and lincomycin at 1/4 X minimum inhibitory concentration (MIC), 1 X MIC and 4 X MIC against a serum-resistant Staphylococcus aureus and a serum-resistant Staphylococcus epidermidis strain in broth, in serum with and without the presence of leukocytes and in Hank's medium in combination with leukocytes alone. Against both test strains, lincomycin in broth and serum was similarly effective, whereas against S. aureus clindamycin in broth was somewhat more active. In the combined test mixture of serum with leukocytes, even a 1/4 X MIC of clindamycin or lincomycin markedly improved leukocyte killing of S. aureus, whereas both compounds could not further enhance the marked leukocyte killing of S. epidermidis, even at inhibitory concentrations. In Hank's medium with leukocytes alone, clindamycin and lincomycin had at the most only a bacteriostatic effect against both test strains.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6490174&dopt=Abstract clindamycin antibiotic Cleocin-T



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Epidemiology of clindamycin resistance in the Bacteroides fragilis group.

Reig M, Campello MG, Baquero F.

A study was made of trends in the susceptibility rates to clindamycin of 338 clinical strains of the Bacteroides fragilis group isolated in the period 1980-83. In 1980, the resistance rate of the species Bact. fragilis to 4 mg/l was only 3.3%, but this percentage increased regularly in 1981 (6.2%), 1982 (15.5%) and reached 19.6% in 1983. Resistance rates in other species of the group (Bact. distasonis, Bact. vulgatus, Bact. thetaiotaomicron) were already high in 1980 and no relevant increase has been documented since then. In order to asses the relationship between clindamycin resistance and hospitalization or macrolides-lincosamides consumption, 184 faecal strains of the Bact. fragilis group isolated from non-treated in-patients, out-patients and healthy volunteers were studied for clindamycin resistance. An unexpectedly high rate of resistance (around 25%) was found in all groups. Resistant strains appeared heterogeneous with regard to phagetype. For unknown reasons, clindamycin resistance seems to be widespread among intestinal Bacteroides strains of the human population, at least in our region.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6520060&dopt=Abstract clindamycin antibiotic Cleocin-T



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Therapeutic efficacy and pharmacokinetic properties of rifampicin in a Bacteroides fragilis intra-abdominal abscess.

Fu KP, Lasinski ER, Zoganas HC, Kimble EF, Konopka EA.

The efficacy of rifampicin in treating a Bacteroides fragilis infection was investigated and compared to clindamycin and metronidazole in an experimental model of intra-abdominal abscess in mice. Rifampicin, when given subcutaneously, showed activity superior to that of clindamycin in reducing the incidence of abscess formation as well as the number of Bacteroides organisms recovered from the abscess, and rifampicin was comparable in efficacy to metronidazole when given orally at the same dose level. The comparative pharmacokinetic properties of rifampicin and clindamycin demonstrated that the peak serum and abscess levels reached with rifampicin were significantly higher than those of clindamycin. The half-life of rifampicin in serum and in the abscess was longer than that of clindamycin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6520063&dopt=Abstract clindamycin antibiotic Cleocin-T