antibioticsbooks

138 PART 2 Antibacterial Drugs
Spectrum: clindamycin
Good: many Gram-positive anaerobes, Plasmodium
species (malaria), Streptococcus pyogenes
Moderate: Staphylococcus aureus (including some
MRSA), Gram-negative anaerobes, Chlamydia
trachomatis, Pneumocystis jirovecii, Actinomyces,
Toxoplasma
Poor: enterococci, Clostridium difficile, Gramnegative
aerobes
Adverse Effects
Gastrointestinal: Diarrhea is one of the most common
adverse effects associated with clindamycin.
Clindamycin itself can cause relatively
benign, self-limited diarrhea or can result in
more severe diarrhea resulting from superinfection
with Clostridium difficile. C. difficile–
associated diarrhea and colitis can occur during
or after clindamycin therapy and can be life
threatening. Patients with diarrhea need evaluation
for C. difficile disease, especially if it is
severe, associated with fever, or persists after
the end of clindamycin therapy.
Dermatologic: Rash may occur with clindamycin,
very rarely with severe manifestations such
as Stevens-Johnson syndrome.
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Important Facts
• Clindamycin is a reasonable alternative
drug for the treatment of staphylococcal
infections; however, care must be taken in
interpreting the antibiotic susceptibility of