Cleocin
Effect of clindamycin given alone or with Lactobacillus delbrueckii and Streptococcus thermophilus on 7alpha-dehydroxylation of bile acids in rats.

Gustafsson A, Norin E, Midtvedt T.

Laboratory of Medical Microbial Ecology, Department of Cell and Molecular Biology, Karolinska Institute, Stockholm, Sweden.

OBJECTIVES: To evaluate the influence of clindamycin, given alone or with Lactobacillus delbrueckii and Streptococcus thermophilus to conventional rats, on 7alpha-dehydroxylation of cholic acid to deoxycholic acid. METHODS: The presence of deoxycholic acid was determined by gas-liquid chromatography. The fecal concentration of clindamycin was determined on PDM antibiotic sensitivity medium. Colony-forming units of L. delbrueckii and S. thermophilus were counted on lactic acid bacteria agar, and their ability to deconjugate was determined by thin-layer chromatography. RESULTS: Clindamycin significantly reduced the formation of deoxycholic acid, while the administration of lactobacilli-streptococci at the same time significantly reduced the effect of the antibiotic (p<0.05). CONCLUSIONS: Clindamycin reduced the formation of deoxycholic acid in rats and this effect was diminished by concomitant administration of L. delbrueckii and S. thermophilus. As the given microbes could not 7alpha-dehydroxylate, it seems reasonable to assume that they stimulate microbial species already present in the intestine.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11864249&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
The inhibitory effect of clindamycin on Lactobacillus in vitro.

Aroutcheva A, Simoes JA, Shott S, Faro S.

Department of Obstetrics and Gynecology, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL, USA.

OBJECTIVE: To evaluate the in vitro effect of varying concentrations of clindamycin on Lactobocillus spp. METHODS: Concentrations of clindamycin ranging from 1.95-20,000 microg/ml were studied for their effect on the growth of six strains of Lactobacillus. RESULTS: Clindamycin concentrations between 1.95-31.25 microg/ml had no statistically significant effect on growth of lactobacilli (p > 0.05). Concentrations 125 and 250 microg/ml had a bacteriostatic effect. The mean minimum inhibitory concentration (MIC) for studied Lactobacillus strains was determined as 1,000 microg/ml. CONCLUSION: High concentrations of clindamycin achieved in the vagina by intravaginal application might be inhibitory for Lactobacillus.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11916182&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
An rRNA mutation identifies the apicoplast as the target for clindamycin in Toxoplasma gondii.

Camps M, Arrizabalaga G, Boothroyd J.

Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5124, USA.

Toxoplasma gondii is a protozoan sensitive to several inhibitors of prokaryotic translation (e.g. clindamycin, macrolides and tetracyclines). A priori, two prokaryotic-like organelles, the 'apicoplast' (a non-photosynthetic plastid) and the mitochondrion, are likely targets for these drugs. Without using overt mutagenesis, we selected two independent clones (ClnR-4 and ClnR-21) with strong and stable clindamycin resistance. Several lines with substantial but lower levels of resistance were also isolated with (XR-46) or without (ClnR-23) overt mutagenesis. The ClnR-4 and ClnR-21 mutants uniquely possess a G-->U point mutation at position 1857 of the apicoplast large-subunit rRNA, whereas no mutation was identified in this region for ClnR-23 or XR-46. Position 1857 corresponds to position 2061 in Escherichia coli where it is predicted to bind clindamycin. The mutation is present in all the apicoplast rDNA copies (an estimated 12 per organelle), indicative of a strong selective advantage in the presence of clindamycin. In the absence of drug, however, such a mutation is unlikely to be neutral, as the G is a critical contributor to the transpeptidation reaction and absolutely conserved in all kingdoms. This may explain why ClnR-4 shows a slight growth defect in vitro. These mutants provide direct genetic evidence that apicoplast translation is the target for clindamycin in Toxoplasma. Further, their sensitivity profiles to other antibiotics specific for the large ribosomal subunit (macrolides and chloramphenicol) and, intriguingly, the small subunit (doxycycline) argue that these drugs also target the apicoplast ribosome.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11918815&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Cutaneous adverse reactions to clindamycin: results of skin tests and oral exposure.

Lammintausta K, Tokola R, Kalimo K.

Department of Dermatology, Turku University Central Hospital, 20520 Turku, Finland. kaija.lammintausta tyks.fi

BACKGROUND: Clindamycin is an antibiotic used in anaerobic and severe complicated infections. It is often selected for patients with a history of allergy to other antibiotics. OBJECTIVES: To study the occurrence of clindamycin hypersensitivity and to determine whether skin tests are useful in cases of suspected clindamycin allergy. METHODS: Six patients with an exanthematous rash and a history strongly suggestive of clindamycin hypersensitivity were studied with skin tests and oral exposure. Cases of suspected adverse drug reactions to clindamycin reported to the National Register of Adverse Effects of Drugs (NRAED) in Finland during 1973-2000 were analysed. RESULTS: In the skin tests true-positive patch test reactions were seen in four of six patients, while 22 healthy control patients were negative. One false-positive and one false-negative patch test reaction were seen. During 1973-2000, 29 suspected cases of skin and/or mucosal membranes affected by clindamycin were reported to the NRAED. CONCLUSIONS: Clindamycin hypersensitivity is not common. Delayed-type allergic reactions occur and patch tests are useful in those cases. Oral exposure is the method of choice if possible, as false-negative and false-positive reactions may occur.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11966697&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Antibiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey.

Yingling NM, Byrne BE, Hartwell GR.

The purpose of this study was to determine the prescribing habits of active members of the American Association of Endodontists (AAE) with regard to antibiotics. A one-page, double-sided questionnaire was sent to the active members of the AAE living in the United States. The 1999 mailing list of 3203 members was obtained from the AAE, and the return rate was 50.1% (1606 surveys). With a sample size over 1000, the study was able to distinguish differences to within 0.5% with power = 80% (at alpha = 5%). The data were analyzed using descriptive statistics and chi-square tests of independence. Penicillin VK, 500 mg, 4 times a day, was the first choice antibiotic prescribed by 61.48% of respondents. Clindamycin (Cleocin), 150 mg, 4 times a day, was selected by 29.59%. For those patients with a penicillin allergy, 57.03% prescribed clindamycin and various erythromycin preparations were prescribed by 26.65%. A loading dose was used by 85.14%. The average duration of antibiotic therapy was 7.58 days. Those respondents involved in academics, either part-time or full-time, were significantly more likely to prescribe penicillin VK, 500 mg, 4 times a day at a rate of 85% versus those in part-time or full-time private practice at a rate of 67%. For cases of irreversible pulpitis, 16.76% of responding endodontists prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 53.93% prescribed antibiotics. Almost 12% prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract. For the most part, the majority of the members of the AAE were selecting the appropriate antibiotic for use in orofacial infections, but there are still many who are prescribing antibiotics inappropriately. Although there were trends of improvement in some areas with regards to prescribing antibiotics, there were other areas where there had been no improvement in 25 years. Unless these trends change, our generation and those to come may not have effective antibiotics for use in the management of true orofacial infections.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12026927&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Clindamycin treatment of methicillin-resistant Staphylococcus aureus infections in children.

Frank AL, Marcinak JF, Mangat PD, Tjhio JT, Kelkar S, Schreckenberger PC, Quinn JP.

Department of Pediatrics, College of Medicine, University of Illinois at Chicago, USA.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) with a narrower antibiotic resistance pattern have emerged. There is a risk for the appearance of resistance during clindamycin therapy of erythromycin-resistant MRSA infections because of the linked resistance mechanisms. METHODS: We analyzed clindamycin-susceptible MRSA organisms from children (1987 to 2000) along with clinical data. Antibiotic susceptibilities of organisms were tested, pulsed field gel electrophoresis (PFGE) was done and the linked resistance mechanism was detected by the D test. RESULTS: An average of 11 clindamycin-susceptible MRSA per year were obtained from children since 1993. Of 88 isolates 33 (38%) were erythromycin-resistant. The latter were less often community-acquired (45% vs. 69%), more often from infants <1 month of age (24% vs. 4%) and less likely to be in the community acquisition-associated PFGE Group 1 (62% vs. 87%) than those that were susceptible. The D test was positive in 31 of 33 erythromycin-resistant isolates. A 9-month-old boy with pneumonia/empyema caused by a clindamycin-susceptible, erythromycin-resistant, D test-positive MRSA developed a PFGE-identical clindamycin-resistant isolate and clinical relapse during clindamycin treatment. In contrast a 12-year-old girl with abscesses caused by a similar MRSA developed another abscess after clindamycin therapy, but the organism was unchanged in susceptibility. CONCLUSIONS: Erythromycin resistance was present in 38% of clindamycin-susceptible MRSA in children, and clindamycin resistance was detected during treatment in one child. Clindamycin remains a treatment option if the clinician is notified of the risk by the microbiology laboratory and the clinical situation is suitable.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12182377&dopt=Abstract clindamycin antibiotic Cleocin-T