Cleocin
Tissue penetration of clindamycin in diabetic foot infections.

Duckworth C, Fisher JF, Carter SA, Newman CL, Cogburn C, Nesbit RR, Wray CH.

Department of Medicine, Medical College of Georgia, Augusta 30912.

Serum and tissue samples were obtained during surgery from four diabetics with neuropathy who underwent debridement or amputation for foot infections while receiving clindamycin 600 or 900 mg iv. Clindamycin concentrations were assayed by radioimmunoassay. Clindamycin was detected in all serum and tissue samples (range: 0.04-2.8 mg/kg in tissues and 1.1-11.1 mg/L in serum). In nine of the eleven tissue samples the clindamycin concentration exceeded the MICs reported for many pathogens commonly involved in such infections. In only a single instance was the ratio of tissue to serum concentration < 0.13.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8514652&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Comparative study of bioavailabilities and pharmacokinetics of clindamycin in healthy volunteers and patients with AIDS.

Gatti G, Flaherty J, Bubp J, White J, Borin M, Gambertoglio J.

Division of Clinical Pharmacy, School of Pharmacy, University of California-San Francisco 94143.

The absolute oral bioavailability and pharmacokinetics of clindamycin administered to 16 healthy volunteers and 16 patients with AIDS were compared. Clindamycin was given intravenously (i.v.) (Cleocin phosphate) at a dose of 600 mg as a 25-min infusion and orally (Cleocin hydrochloride) by use of a crossover design in both study groups. Plasma samples were analyzed by gas-liquid chromatography. Plasma drug clearance and volume of distribution at the steady state following the i.v. dose differed between study groups. The clearances were 0.27 +/- 0.06 liter/h/kg in healthy volunteers and 0.21 +/- 0.06 liter/h/kg in AIDS patients (P = 0.014; Mann-Whitney U test); the volumes of distribution at the steady state were 0.79 +/- 0.13 and 0.66 +/- 0.12 liter/kg in healthy volunteers and AIDS patients, respectively (P = 0.005). The elimination half-life did not differ between the two groups. The bioavailability of clindamycin capsules in AIDS patients was approximately 1.5 times that in healthy volunteers (0.53 +/- 0.14 versus 0.75 +/- 0.20; P = 0.002). Peak concentrations following the oral dose were higher in AIDS patients as well (7.7 +/- 2.5 versus 5.3 +/- 1.0 mg/liter; P = 0.0008). Three AIDS patients experienced severe diarrhea following the oral dose; four patients had mild diarrhea following the i.v. dose. No adverse effects were reported by the healthy volunteers. The pharmacokinetic parameters observed in this study for AIDS patients may be useful for the consideration of clindamycin dosage regimens in patients treated for toxoplasmic encephalitis. These findings suggest that the effect of AIDS on drug disposition deserves further investigation, particularly for orally administered drugs.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8517703&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Efficacy of dactimicin plus clindamycin compared with gentamicin plus clindamycin in the treatment of experimental intra-abdominal infections in rats.

Nord CE, Lahnborg G.

Department of Microbiology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.

A reproducible experimental model of intra-abdominal infections in rats has been developed in order to simulate intra-abdominal sepsis in patients. A 1-cm segment of ileum was isolated on its vascular pedicle. The intestine was then divided at each end of the segment and intestinal continuity was re-established by an end-to-end anastomosis. Dactimicin is a new aminoglycoside antibiotic with a broad antibacterial spectrum including both aerobic Gram-positive and Gram-negative bacteria. The experimental model was used to compare the efficacy of dactimicin in combination with clindamycin with the combination gentamicin/clindamycin in the treatment of intra-abdominal infections. Of the untreated animals, 70% died within two days. Animals treated with dactimicin plus clindamycin or gentamicin plus clindamycin exhibited significantly decreased mortality and increased cure rates during the experimental period. Only 5% of these animals died. Thus the combination dactimicin/clindamycin seems to be useful in the treatment of intra-abdominal infections.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2097144&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Influence of antibiotics on intestinal tract survival and translocation of environmental Pseudomonas species.

George SE, Kohan MJ, Whitehouse DA, Creason JP, Claxton LD.

Health Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711.

The environmental release of microorganisms has prompted the investigation of potential health effects associated with their release. In this study, survival and translocation to the spleen and liver of several environmental Pseudomonas spp. were investigated in antibiotic-treated mice. Pseudomonas aeruginosa BC16 and P. maltophilia BC6, isolated from a commercial product for polychlorinated biphenyl degradation; P. aeruginosa AC869, a 3,5-dichlorobenzoate degrader; and P. cepacia AC1100, an organism that metabolizes 2,4,5-trichlorophenoxyacetic acid were examined for their survival capabilities in the intestines of mice dosed with clindamycin, kanamycin, rifampin, or spectinomycin. A mouse intestinal isolate, strain PAMG, was included in the study. Following antibiotic pretreatment (1 mg twice daily for 3 days), mice were dosed by gavage with 10(9) CFU of each Pseudomonas strain. At the end of the 5-day test period, strains AC869 and PAMG survived in kanamycin-, rifampin-, spectinomycin-, and clindamycin-treated animals. A statistically significant (P less than 0.05) increase in survival of strain PAMG was observed in clindamycin-, kanamycin-, and spectinomycin-treated mice for the test period. Treatment with clindamycin or rifampin increased (P less than 0.05) survival of strain BC6, an organism resistant to both antibiotics. However, strain BC6 was detected only in rifampin-treated mice at the end of the 5-day test period. Strain BC16, a clindamycin-resistant strain, was detected in clindamycin-treated mice and the untreated control animals. Rifampin had a negative effect (P less than 0.05) on strain AC869 and PAMG survival. Translocation to the spleen was observed in spectinomycin- and clindamycin-treated mice but was not detected in kanamycin- or rifampin-treated animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2116756&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
Bioavailability of clindamycin during peritoneal dialysis.

Eng RH, Smith SM, Buccini F, Naumoff M, Sastrasinh S.

Medical Service, Veterans Administration Medical Center, East Orange, N.J.

Clindamycin phosphate becomes biologically active only with cleavage of the phosphate ester bond. A rat model was used to examine the amount of biologically active clindamycin attainable in the dialysate and in the blood during peritoneal dialysis. Intravenous administration of 10 mg/kg clindamycin phosphate alone without peritoneal dialysis produced peak blood levels of 15-20 micrograms/ml. With peritoneal dialysis, blood levels of less than 5 micrograms/ml were achieved. When clindamycin phosphate was added to the dialysis fluid at an initial concentration of 10 mg/ml, less than 5 micrograms/ml of the active antibiotic can be detected in the dialysis return fluids. Even in rats with induced peritonitis, less than 15 micrograms/ml could be found in the dialysis returns. With or without peritonitis, less than 5 micrograms/ml of active clindamycin was attained in blood from peritoneal installation alone. The conversion of the ester to the active compound appears to be the major problem. It is recommended that in those clinical situations in which the patient requires peritoneal dialysis, an alternate antimicrobial agent be used in place of clindamycin to avoid infections in the abdominal cavity or the blood while under therapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2155762&dopt=Abstract clindamycin antibiotic Cleocin-T



Cleocin
In vitro and in vivo effects of subinhibitory concentrations of clindamycin on experimental Klebsiella pneumoniae sepsis.

Arbo A, Mancilla J, Alpuche C, Santos JI.

Department of Infectious and Parasitic Diseases, Hospital Infantil de Mexico Federico Gomez, Mexico City.

We studied the effect of subinhibitory doses of clindamycin on the course of experimental Klebsiella pneumoniae sepsis. Wistar rats were injected intraperitoneally with an inoculum containing 5 x 10(6) colony-forming units of K. pneumoniae resistant to clindamycin (minimum inhibitory concentration greater than 128 micrograms/ml) and then distributed to receive clindamycin 10 mg/kg/day or placebo for 10 days. All animals were bacteremic at 3 h. When the magnitude of bacteremia was compared, no difference was seen during the first 24 h; however, by 72 h the clindamycin-treated group had a significant decrease in the number of colony-forming units per milliliter blood (p less than 0.01). The mortality rate showed a tendency to decrease in the treated group (0%) as compared with the control group (30%). By 120 h, 3 of the 9 (33%) surviving animals from the control group were still bacteremic versus 0 of 11 (0%) in the clindamycin-treated group. These results suggest that subinhibitory clindamycin therapy can improve bacterial clearance and survival during the course of experimental K. pneumoniae sepsis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2209167&dopt=Abstract clindamycin antibiotic Cleocin-T