antibioticsbooks

Lincosamides
18
Agent: clindamycin
Clindamycin can be considered a mix of vancomycin
and metronidazole; it has attributes of each drug, but
it is not quite as good as either one alone. Clindamycin
is an alternative when treatment requires Grampositive
activity (as with beta-lactam allergies),
but it has more variable activity than vancomycin
against such pathogens as MRSA and S. pyogenes.
Clindamycin also covers many anaerobic organisms,
but there is a higher level of resistance among the
Gram-negative anaerobes (such as B. fragilis) than
with metronidazole. Because of these limitations and
clindamycin’s tendency to cause GI toxicity, it is best
used empirically for nonsevere infections of the skin
and oral cavity, or as definitive therapy when susceptibilities
are known.
Mechanism of Action
Clindamycin binds at a site on the 50S ribosome
right next to where the macrolides bind, and acts
similarly in preventing protein synthesis by preventing
the ribosome from moving on to adding
another amino acid in the protein chain.