Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Clindamycin Systemic [keywords]
- Prolonged usage of intravaginal clindamycin cream combined with ampicillin for the management of PPROM - a case report. [Journal Article]
- J Turk Ger Gynecol Assoc 2011; 12(2):124-6.
Prolonged PPROM may be catastrophic both for the mother and fetus due to ascending infections. The decision was expectant management in the setting of a spontaneous preterm premature rupture of membranes (PPROM) case and the prevention of chorioamnionitis was essential. We aimed to describe maternal and neonatal outcomes in expectant management of PPROM beginning from the 24(th) gestational week (GW) of pregnancy up to the 34(th) week under treatment with continuous usage of intravaginal clindamycin cream. We concluded that expectant active management of PPROM with antibiotics may be a suitable treatment option in carefully selected patients after receiving the patient's approval. Intravaginal clindamycin cream may be combined with systemic antibiotics (ampicillin and erythromycin) and may be a maintenance single drug for the prophylaxis of ascending vaginal infections.
- Treatment of acne vulgaris in pregnant patients. [Journal Article]
- Dermatol Ther 2013 Jul-Aug; 26(4):302-11.
The management of acne vulgaris in the setting of pregnancy raises important clinical considerations regarding the efficacy and safety of acne treatments in this special patient population. Particular challenges include the absence of safety data, discrepancy in safety data between different safety rating systems, and lack of evidence-based recommendations for the treatment of acne during pregnancy. Nonetheless, many therapeutic options exist, and the treatment of acne in pregnant women can be safely and often effectively accomplished. For mild or moderate disease, patients can be treated with topical antimicrobial agents, anti-inflammatory agents, as well as glycolic and salicylic acid. Several topical agents, notably benzoyl peroxide, previously viewed as potentially dangerous are cited by many sources as being considered safe. When necessary, systemic therapies that can be safely added include penicillins, amoxicillin, cephalosporins, erythromycin, clindamycin, and tetracyclines or sulfonamides, depending on the stage of fetal development. Adjunct therapy may include phototherapy or laser treatments. Physicians should work with this often highly motivated, safety-conscious patient population to tailor an individualized treatment regimen. This treatment regimen will likely shift throughout the different stages of fetal development, as distinct safety considerations are raised prior to conception as well as during each of the trimesters of pregnancy. Important considerations regarding acne management in breast-feeding mothers is also discussed.
- Recurrent furunculosis: Efficacy of the CMC regimen--skin disinfection (chlorhexidine), local nasal antibiotic (mupirocin), and systemic antibiotic (clindamycin). [Journal Article]
- Scand J Infect Dis 2013 Nov; 45(11):837-41.
The treatment of recurrent furunculosis is poorly documented and represents a public health challenge. The medical care of this disease is often disappointing, especially as the disease evolution is uncertain and relapses occur. We report the efficacy and safety of our CMC regimen: skin disinfection (chlorhexidine), local nasal antibiotic (mupirocin), and systemic antibiotic (clindamycin).Patients attending our institution during the period 2006-2012 for recurrent furunculosis (≥ 4 episodes/y) were enrolled in the study. Clinical and bacteriological data were collected. Staphylococcus aureus colonization was also investigated in close contacts, and carriers were treated. Patients were treated with the CMC regimen: skin disinfection with chlorhexidine for 21 days, nasal mupirocin ointment for 5 days, and oral clindamycin 1800-2400 mg for 21 days.Nineteen patients were included. Their mean age was 36 ± 14.5 y and the male to female sex ratio was 1.1. Screening swabs from all sites were S. aureus-positive in 63% (n = 12), including 4 methicillin-resistant S. aureus (MRSA). Before the CMC regimen, the median time to relapse was 31 days (mean 52 days). The mean number of recurrences was 5.5 ± 2.4/y. After the CMC regimen, among 16 patients who had a complete follow-up, 14 were healed beyond 9 months. Two recurrences occurred, 1 in an MRSA carrier and 1 in a patient with an insufficiently treated dermatosis. No serious side effect occurred that required the cessation of treatment.There are 2 major routes involved in recurrent furunculosis: risk factors and staphylococcal colonization of close contacts. Our procedure is safe and effective, with 87% remission beyond 9 months. It merits testing on larger numbers of participants.
- Corticosteroids in peritonsillar abscess treatment: a blinded placebo-controlled clinical trial. [Journal Article]
- Laryngoscope 2014 Jan; 124(1):97-103.
Sore throat is a common, benign emergency department (ED) presentation; however, peritonsillar abscess (PTA) is a complication that requires aggressive management. Use of systemic corticosteroids (SCSs) in PTA is occurring without clear evidence of benefit. This study examined the efficacy and safety of SCS treatment for patients with PTA.Randomized, double-blind, placebo-controlled trial.A controlled trial with concealed allocation and double-blinding was conducted at two Canadian EDs. Following written informed consent, eligible patients received 48 hours of intravenous clindamycin and a single dose of the study drug (dexamethasone [DEX] or placebo [PLAC], intravenously [IV]). Follow-up occurred at 24 hours, 48 hours, and 7 days. The primary outcome was pain; other outcomes were side effects and return to normal activities/diet.A total of 182 patients were screened for eligibility; 41 patients were enrolled (21 DEX; 20 PLAC). At 24 hours, those receiving DEX reported lower pain scores (1.4 vs. 5.1; P = .009); however, these differences disappeared by 48 hours (P = .22) and 7 days (P = .4). At 24 hours, more patients receiving DEX returned to normal activities (33% vs. 11%) and dietary intake (38% vs 25%); however, these differences were not significant and disappeared by 48 hours and 7 days. Side effects were rare and did not differ between groups (P > .05).Combined with PTA drainage and IV antibiotics, 10 mg IV DEX resulted in less pain at 24 hours when compared to PLAC, without any serious side effects. This effect is short-lived, and further research is required on factors associated with PTA treatment success.
- Antimicrobial susceptibility and molecular typing of MRSA in cystic fibrosis. [Journal Article]
- Pediatr Pulmonol 2014 Mar; 49(3):230-7.
The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in cystic fibrosis (CF) patients in the United States is approximately 25%. Little is known about the relative proportion of hospital- versus community-associated strains or the antimicrobial susceptibility of MRSA in different CF centers. We hypothesized that the majority of MRSA isolates obtained from children with CF are those endemic in the hospital and that those associated with community acquisition (SCCmec IV) would be more resistant than typically seen in non-CF MRSA isolates.We studied MRSA strains from seven pediatric CF centers to determine the clonal distribution based on DNA sequencing of the staphylococcal protein A gene (spa typing), the type of staphylococcal chromosomal cassette mec (SCCmec), and the proportion of strains with Panton-Valentine leukocidin (PVL). Antimicrobial susceptibility to systemic and topical antibiotics was compared between different MRSA types.We analyzed 277 MRSA isolates from unique patients (mean age 11.15 ± 4.77 years, 55% male). Seventy % of isolates were SCCmec II PVL negative and the remainder SCCmec IV. Overall 17% MRSA strains were PVL positive (all SCCmec IV). Spa typing of 118 isolates showed most of the SCCmec II strains being t002, while SCCmec IV PVL positive isolates were t008, and SCCmec IV PVL negative isolates represented a variety of spa-types. The proportions of SCCmec II strains and spa-types were similar among centers. Overall rates of resistance to trimethoprim-sulfamethoxazole (4%), tetracycline (7%), tigecycline (0.4%), linezolid (0.4%) as well as fosfomycin (0.4%), fusidic acid (3%), and mupirocin (1%) were low. No strains were resistant to vancomycin. SCCmec II strains had higher rates of resistance to ciprofloxacin and clindamycin (P < 0.001) than SCCmec IV strains.In this U.S. study, most MRSA isolates in the pediatric CF population were SCCmec II PVL negative. Rates of resistance were low, including to older and orally available antibiotics such as trimethoprim-sulfamethoxazole. Pediatr Pulmonol. 2014; 49:230-237. © 2013 Wiley Periodicals, Inc.
- Skin conditions: emerging drug-resistant skin infections and infestations. [Case Reports, Journal Article, Review]
- FP Essent 2013 Apr.:17-23.
Methicillin-resistant Staphylococcus aureus (MRSA) skin infections are increasingly common. Automated microbiology systems are now available to detect MRSA and to determine antibiotic resistance patterns. Abscesses should be drained and antibiotics administered, with systemic antibiotics used to manage more severe infections. Until sensitivities are known and depending on local resistance rates, clindamycin is an option for empiric management of stable patients without bacteremia. For patients who are more ill, linezolid and vancomycin are alternatives, the latter being first-line treatment for children hospitalized with MRSA skin infections. Drug resistance also occurs in head lice management. Although topical permethrin is still the first-line drug management, its effectiveness has decreased due to permethrin-resistant strains. Patients who do not benefit from 2 applications of permethrin can be treated with topical malathion or topical ivermectin. Though not approved by the Food and Drug Administration (FDA) for treating head lice, oral ivermectin is sometimes used for difficult-to-treat cases. Permethrin is also the first-line management for scabies, though there is a concern that permethrin-resistant scabies may soon occur. For patients with scabies who do not benefit from topical treatment, oral ivermectin is recommended by the Centers for Disease Control and Prevention, although it is not approved by the FDA for this purpose.
- Concentrations of amoxicillin and clindamycin in teeth following a single dose of oral medication. [Journal Article]
- Clin Oral Investig 2014 Jan; 18(1):35-40.
The main purpose of this study is the detection of amoxicillin and clindamycin concentrations in teeth.Eleven patients received 2 g of amoxicillin, and 11 patients received 600 mg of clindamycin in a single dose of oral medication at least 60 min prior to tooth extraction due to systemic diseases. The concentrations were determined in crowns and roots separately using liquid chromatography-tandem mass spectrometry (LC-MS-MS).Amoxicillin (13 samples) and clindamycin (12 samples) were detected in the samples of the root and crown preparations of the extracted teeth. The mean concentration of amoxicillin was 0.502 μg/g in the roots and 0.171 μg/g in the crowns. The mean concentration of clindamycin was 0.270 μg/g in the roots and 0.064 μg/g in the crowns.A single dose of oral amoxicillin and clindamycin leads to concentrations of both antibiotics in teeth which exceed the minimal inhibition concentration of some oral bacteria.The proof of antibacterial activity in dental hard tissue after oral single-dose application is new. The antimicrobial effect of amoxicillin and clindamycin concentrations in roots of teeth may be of clinical relevance to bacterial reinfection from dentinal tubules.
- Diffuse infiltrating retinoblastoma coexisting with ocular toxoplasmosis. [Journal Article]
- Int Ophthalmol 2014 Feb; 34(1):137-40.
A 4-year-old boy presented with unilateral endophthalmitis and echography revealed an abscess in the vitreous cavity. A pars plana vitrectomy with intravitreal antibiotic injections was performed with a presumed diagnosis of endophthalmitis; however, the patient returned after 10 days with fibrin reaction in the anterior chamber, iris nodules and cataract. The vitreous sample from the vitrectomy showed Toxoplasma gondii parasite, so he was treated with intravitreal clindamycin and lensectomy. The postoperative fundus examination revealed multifocal white patches with calcified deposits and cytology proved the diagnosis of retinoblastoma. Enucleation was performed in addition to systemic chemotherapy. To our knowledge, this is the first reported case of the coexistence of retinoblastoma and ocular toxoplasmosis.
- Clindamycin phosphate 1.2% and tretinoin 0.025% gel for rosacea: summary of a placebo-controlled, double-blind trial. [Journal Article, Randomized Controlled Trial]
- J Drugs Dermatol 2012 Dec; 11(12):1410-4.
Rosacea is a common, chronic, and poorly understood dermatological condition characterized by an inflammatory component composed of papules and pustules and a vascular component composed of flushing and erythema. Current treatment options include topical, systemic, and light-based methods, each of which focuses on either the inflammatory or the vascular component. Retinoids are not routinely indicated as treatment because of the common conception that they would be too inflammatory for the sensitive rosacea patient. However, photodamage may play a role in rosacea and tretinoin is well-known to repair photodamage. Thirty rosacea subjects were enrolled to assess their response to the use of clindamycin phosphate 1.2% and tretinoin 0.025% gel (ZIANA; Medicis Pharmaceutical Corporation, Scottsdale, AZ) for a period of 12 weeks. The results showed a dramatic decrease in pustules and papules without any significant inflammation or overall intolerance. No improvement in facial redness was achieved. Based on our results, more investigation of topical retinoids for rosacea treatment is prudent.
- Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients. [Journal Article, Research Support, Non-U.S. Gov't]
- Rev Soc Bras Med Trop 2012 Dec; 45(6):717-22.
In venous ulcers, the presence of Staphylococcus aureus and coagulase-negative staphylococcus resistance phenotypes can aggravate and limit the choices for treatment.Staphylococcus isolated from 69 patients (98 ulcers) between October of 2009 and October of 2010 were tested. The macrolide, lincosamide, streptogramin B (MLS B) group resistance phenotype detection was performed using the D-test. Isolates resistant to cefoxitin and/or oxacillin (disk-diffusion) were subjected to the confirmatory test to detect minimum inhibitory concentration (MIC), using oxacillin strips (E-test®).The prevalence of S. aureus was 83%, and 15% of coagulase-negative staphylococcus (CoNS). In addition were detected 28% of methicillin-resistant Staphylococcus aureus (MRSA) and 47% of methicillin-resistant coagulase-negative staphylococcus (MRCoNS). Among the S. aureus, 69.6% were resistant to erythromycin, 69.6% to clindamycin, 69.6% to gentamicin, and 100% to ciprofloxacin. Considering the MRSA, 74% were highly resistant to oxacillin, MIC ≥ 256µg/mL, and the MLS Bc constitutive resistance predominated in 65.2%. Among the 20 isolates sensitive to clindamycin, 12 presented an inducible MLS B phenotype. Of the MRCoNS, 71.4%were resistant to erythromycin, ciprofloxacin and gentamicin. Considering the isolates positive for β-lactamases, the MIC breakpoint was between 0.5 and 2µg/mL.The results point to a high occurrence of multi-drug resistant bacteria in venous ulcers in primary healthcare patients, thus evidencing the need for preventive measures to avoid outbreaks caused by multi-drug resistant pathogens, and the importance of healthcare professionals being able to identifying colonized versus infected venous ulcers as an essential criteria to implementing systemic antibacterial therapy.