Cleocin
Interaction between penicillin, clindamycin or metronidazole and gentamicin against species of clostridia and anaerobic and facultatively anaerobic gram-positive cocci.

Brook I, Walker RI.

Seven anaerobic and facultative Gram-positive cocci and 12 clostridial species were tested for in-vitro and in-vivo susceptibilities to penicillin, clindamycin, and metronidazole, used singly or in combination with gentamicin. The in-vitro tests consisted of determination of minimal inhibitory concentration (MIC), done without or with constant amounts of gentamicin. When used alone or in combination with penicillin or metronidazole, gentamicin had negligible effects on the bacteria. When used with clindamycin, gentamicin significantly reduced the MIC for one strain each of Peptococcus magnus and Clostridium difficile. The in-vivo tests were carried out in mice and consisted of studying the bacterial contents of abscesses induced by subcutaneous injection of bacterial suspensions. Synergy between gentamicin and penicillin, clindamycin or metronidazole was shown respectively in five, three and one strain. Consistency between in-vitro and in-vivo findings was present in the above mentioned strains only between gentamicin and clindamycin. The synergy between penicillin, clindamycin or metronidazole and gentamicin in Gram-positive anaerobic and facultative organisms may have clinical implications.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3972757&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Stability and cost analysis of clindamycin-gentamicin admixtures given every eight hours.

Mansur JM, Abramowitz PW, Lerner SA, Smith RB, Townsend RJ.

Stability and costs of a mixture of clindamycin and gentamicin in a single carrier solution for every-eight-hour i.v. administration were analyzed. Duplicate solutions containing clindamycin 900 mg (as the phosphate salt) and gentamicin 100 mg (as the sulfate salt) in 5% dextrose injection 150 mL in flexible plastic containers were prepared. Samples withdrawn at 0-24 hours were visually inspected and assayed for content of both drugs. Clindamycin concentrations were determined by high-performance liquid chromatography and gentamicin concentrations by fluorescence-polarization immunoassay. Preparation and administration times were measured in two trials to determine cost differences between every-eight-hour administration of the two-antibiotic mixture and separate administration of the two drugs (four daily doses of clindamycin and three of gentamicin). No precipitate was seen. Concentrations of both drugs after 24 hours were greater than 90% of initial concentrations. Total daily costs (per patient) for labor, drug, and carrier solution were $3.08 less when the two drugs were mixed and administered every eight hours. At the concentrations studied, clindamycin and gentamicin mixed together in 5% dextrose injection are stable for 24 hours. Administration of this drug mixture every eight hours is safe and less costly than separate administration of the two drugs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3976680&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Disc diffusion method to screen for high-level resistance to clindamycin and erythromycin in the Bacteroides fragilis group.

Callihan DR, Nolte FS.

High-level clindamycin resistance in Bacteroides species was investigated by measuring zone sizes surrounding 2 micrograms clindamycin and 60 micrograms erythromycin discs, using a nonstandardized disc diffusion method, and by determining minimal inhibitory concentrations (MIC). The absence of a zone of inhibition surrounding either disc was predictive for all isolates having high-level resistance to both antibiotics (MIC greater than 256 micrograms/ml), characteristic of macrolide-lincosamide-streptogramin (MLS) cross-resistance. Although zone size could not be used as an absolute predictor of MIC, a clindamycin zone diameter of less than 17 mm was suggestive of strains with a moderate level of clindamycin resistance (MIC greater than or equal to 8 micrograms/ml), regardless of erythromycin zone size. Disc diffusion testing using a combination of clindamycin and erythromycin discs can be a useful screening method for detection of clindamycin-resistant Bacteroides species, occurring either alone or as part of the MLS resistance phenotype.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3979019&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Interaction of subminimal inhibitory concentrations of clindamycin and gram-negative aerobic organisms: effects on adhesion and polymorphonuclear leukocyte function.

Lianou PE, Bassaris HP, Votta EG, Papavassiliou JT.

The effect of pre-incubation of Pseudomonas aeruginosa, Klebsiella pneumoniae and Proteus mirabilis with sub-inhibitory concentrations (sub MICs) of clindamycin on the adherence of these organisms was studied. Culturing these organisms in the presence of clindamycin (4 mg/l) resulted in significant enhancement of adherence for Ps. aeruginosa and Pr. mirabilis and decreased adherence for K. pneumoniae. Furthermore, the effect of pre-exposure to clindamycin on polymorphonuclear leukocyte (PMNLs) function against these organisms was determined. Filtrates of Pr. mirabilis pre-exposed to clindamycin promoted PMNL chemotaxis. No effect on chemotaxis was noted with the filtrates of clindamycin treated Ps. aeruginosa and K. pneumoniae. PMNL phagocytosis for all the organisms was increased after they were pre-exposed to clindamycin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4008380&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Compatibility of clindamycin phosphate with cefotaxime sodium or netilmicin sulfate in small-volume admixtures.

Foley PT, Bosso JA, Bair JN, Townsend RJ.

The stability and compatibility of clindamycin phosphate plus either cefotaxime sodium or netilmicin sulfate in small-volume intravenous admixtures were studied. Admixtures containing each drug alone and two-drug admixtures of clindamycin phosphate plus cefotaxime sodium or netilmicin sulfate were prepared in 100 mL of 5% dextrose injection and 0.9% sodium chloride injection in both glass bottles and polyvinyl chloride (PVC) bags. Final concentrations of clindamycin, cefotaxime, and netilmicin were 9, 20, and 3 mg/mL, respectively. All solutions were prepared in duplicate and stored at room temperature (24 +/- 2 degrees C). Samples were visually inspected, tested for pH, and assayed for antibiotic concentration using stability-indicating assays at 0, 1, 4, 8, 16, and 24 hours for admixtures in glass bottles and at 0, 8, and 24 hours for admixtures in PVC bags. No substantial changes in color, clarity, pH, or drug concentration were observed in any of the solutions. Clindamycin phosphate is compatible with cefotaxime sodium or netilmicin sulfate in 5% dextrose and 0.9% sodium chloride injections in glass bottles or PVC bags for 24 hours.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4014236&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Clindamycin levels in reproductive tissues.

Johnson SR, Petzold CR, Galask RP.

Clindamycin is widely used in a variety of obstetric and gynecologic infections. Despite in vitro and clinical evidence of activity against anaerobes, genital organ tissue levels resulting from intravenous administration of the drug have not previously been reported. Following a single intravenous infusion of 600 mg of clindamycin phosphate, tissue levels were determined in operative specimens obtained from ten women. Specimens of cervix, uterus, fallopian tube, and ovary were obtained, and mean Clindamycin levels for each site were: cervix, 2.63 micrograms/ml; endometrium, 5.58 micrograms/ml; myometrium, 2.39 micrograms/ml; fallopian tube, 2.96 micrograms/ml; and ovary, 3.74 micrograms/ml. The mean serum level was 6.26 micrograms/ml at the time of uterine artery interruption. The clindamycin concentrations at all sites exceeded the usual therapeutic minimal inhibitory concentration, substantiating the usefulness of clindamycin in obstetric and gynecologic anaerobic infections.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4025669&dopt=Abstract clindamycin antibiotic Cleocin-T