Infections caused by Clindamycin sensitive strains, especially in patients who are hypersensitive to penicillin and / or cephalosporins. Infections of the upper respiratory tract: tonsillitis, pharyngitis, sinusitis, otitis media and scarlet fever. Infections of the lower respiratory tract: bronchitis, pneumonia, empyema and lung abscess. Infections of bones and joints: osteomyelitis and sepsis arthritis. Infections within the teeth: periodontium abscess and periodontitis. Infections of the skin and soft tissues: acne, boil, cellulitis, impetigo, rose, abscesses, wound infections and naevi. Infections in the pelvic and abdominal cavity (in combination with an antibiotic effective against Gram-negative anaerobic bacteria): endometritis, vaginitis, ovarian abscess, peritonitis and abdominal abscesses. In addition: specific cases of sepsis, endocarditis and toxoplasmatic encephalitis in the case of immunosuppression or AIDS (in high doses in combination with pyrimethamine as an alternative treatment in the case of hypersensitivity to sulphonamides, also to avoid relapses).
Composition:
One capsule contains 300 mg of clindamycin in the form of a hydrochloride. The preparation contains lactose.
Action:
Lineosamide antibiotic. Clindamycin inhibits the biosynthesis of bacterial proteins. Depending on the concentration and sensitivity of microorganisms, it is bacteriostatic or bactericidal. Sensitive strains include: Gram-positive aerobic bacteria (Staphylococcus spp., Pneumococcus spp. andStreptococcus spp. exceptStreptococcus faecalis), anaerobic Gram-positive bacteria (Peptococcus spp. andPeptostreptococcus spp.) and anaerobic Gram-negative bacteria (Bacteroides spp., Fusobacterium spp., Eubacterium and Actinomyces). Bioavailability after oral administration is 90%. Cmax is achieved in 45 min. It is metabolized in the liver. The main metabolites are clindamycin N-desmethyl and clindamycin sulphoxide. 10% of the dose is excreted as a biologically active ingredient in the urine and 4% in the faeces. T0,5 in plasma is 2.4 h and is not significantly altered by hemodialysis or peritoneal dialysis. For medium to severe hepatic impairment, the half-life of clindamycin is prolonged; accumulation occurs, however, rarely if the dose is given at 8-hour intervals.
Contraindications:
Hypersensitivity to the preparation ingredients and / or lincomycin. acute viral infections of the upper respiratory tract. Clindamycin does not achieve a sufficient concentration in the cerebral spinal fluid, so it should not be used to treat meningitis.
Precautions:
In the case of long-term treatment, it is necessary to periodically check the kidneys and liver function. Monitoring of plasma clindamycin is recommended, especially when high doses are used. Particularly cautiously use in patients: with bronchial asthma, a tendency to allergy; with a history of gastrointestinal disease (especially colitis); in patients with hepatic and renal impairment (monitor the concentration of the drug in the blood). Clindamycin has the properties of blocking neuromuscular conduction - especially cautiously used in patients who are taking other neuromuscular blocking drugs. For any patient who has experienced diarrhea due to the use of an antibiotic, the possibility of pseudomembranous colitis should be considered; after determining the diagnosis of this disease, the antibiotic should be discontinued and appropriate treatment instituted. Antibiotic treatment can lead to excessive growth of non-susceptible organisms; in the case of such superinfections, appropriate treatment should be instituted immediately. Due to the lactose content, the drug is not administered to patients with rare inherited galactose intolerance, Lapp lactose deficiency or glucose-galactose malabsorption.
Pregnancy and lactation:
There is insufficient data on the safety of the preparation during pregnancy. The preparation can only be used if clearly needed after careful assessment of the benefits and risks.Clindamycin is excreted in human milk at a concentration of 0.7 μg to 3.8 μg, therefore it is not advisable to use it in breastfeeding mothers.
Side effects:
Common: abdominal pain, nausea, vomiting, diarrhea, oesophagitis, abnormal liver function tests (bilirubin, AST, alkaline phosphatase). Uncommon: transient neutropenia (leukopenia) and eosinophilia, agranulocytosis and thrombocytopenia (no direct etiological dependence with concomitant clindamycin treatment), maculopapular rash, urticaria, generalized mild to moderately pronounced palpate-like rash similar to Stevens-Johnson syndrome, erythema multiforme. Rare: pruritus, rash, urticaria, vaginitis and cases of exfoliative dermatitis. Very rare: anaphylactic reactions, pseudomembranous colitis (slight watery to acute chronic diarrhea, leukocytosis, fever, acute abdominal cramps, sometimes accompanied by the presence of blood and mucus in the stool potentially leading to peritonitis, shock and toxic dilation of the colon), jaundice, inflammation polyarthritis.
Dosage:
Orally. Adults: 1 to 2 capsules 2-3 times a day. The treatment regimen should be adapted to the degree of infection, the patient's condition and pathogen sensitivity: 600-1200 mg per day in mild and severe infections, 1200-1800 mg per day in severe infections. In infections caused by β-haemolytic streptococci, treatment should last at least 10 days. Toxoplasmatic encephalitis in the case of immunosuppression or AIDS: intravenously 600-1200 mg 4 times a day for 2 weeks, then orally 300-600 mg 4 times a day; the duration of the entire treatment is from 8 to 12 weeks; used in combination with oral pyrimetatine 25-75 mg daily for 8-10 weeks; If high doses of pyrimethamine are used, 10-20 mg of folic acid should be given at the same time.Way of giving: during meals or between meals. To avoid inflammation of the esophagus, the capsules should be taken with a glass of water.
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