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Author: Dr Weng Chyn Chan MB ChB, Dept of Dermatology Waikato Hospital, Hamilton, New Zealand, 2004.
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Clindamycin is a lincosamide antibiotic. It is used to treat infections due to susceptible bacteria.
Clindamycin can be used topically, orally or intravenously. In New Zealand (July 2017), it is available on prescription. In other countries, it may also be available as a topical foam, vaginal cream and oral suspension.
Clindamycin is quickly absorbed after oral administration, and absorption is not affected by food.
Dermatologists prescribe clindamycin for a variety of skin conditions (skin and soft tissue infection).
Indications for clindamycin solution, gel or lotion include:
Clindamycin is also available to treat acne in combination with benzoyl peroxide.
Clindamycin vaginal cream is used to treat bacterial vaginosis.
Together with rifampicin, uses for oral clindamycin include:
Clindamycin is active against gram-positive organisms (Staphylococcus aureus, Staphylococcus epidermidis, streptococci and Cutibacterium) and gram-negative organisms (Bacteroides species). Susceptible organisms include both aerobic and anaerobic bacteria.
Oral clindamycin is generally well tolerated. However, there are significant side effects that may affect some people taking the medicine orally or by injection (they are very rarely seen with the topical preparations).
Clindamycin has been associated with pseudomembranous colitis (inflammation of the bowel); this adverse effect is caused by a toxin produced from an overgrowth of a bacterium, Clostridium difficile (also known as Clostridioides difficile). Symptoms can range from mild diarrhea to severe, persistent diarrhoea with fever, abdominal cramps, the passage of blood and mucus, and fatal colitis.
If significant diarrhoea develops while taking clindamycin, the drug should be stopped and medical advice sought. A stool test may show the presence of the toxin. Treatment depends on the severity of symptoms. Stopping the medication may be enough; however, more severe cases may require hospitalisation for intravenous fluid and antibiotic therapy.
If you are not based in New Zealand, we suggest you refer to your national drug approval agency for further information about medicines (eg, the Australian Therapeutic Goods Administration and the US Food and Drug Administration) or a national or state-approved formulary (eg, the New Zealand Formulary and New Zealand Formulary for Children and the British National Formulary and British National Formulary for Children).
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