Clindamycin use in Dentistry

Clindamycin is unrelated to other agents and inhibits bacterial protein synthesis. Clindamycin is best against gram positive and negative anaerobes; gram negative aerobes are resistant. Although it is broad spectrum, Clindamycin is best indicated to treat serious infections by anaerobes. Contraindications against clindamycin include a history of severe GI disease, colitis, and diarrhea. There are no cross allergies (except possibly with lincomycin). It has good absorption (90%) and is not inactivated by gastric acid. 92-94% is bound to serum protein. The biologic half-life is long, 2.4-3 hours. Clindamycin is metabolized through the liver (dose reduction in severe hepatic disease). The oral dose is 150-300 mg qid, with a max dose of 1.8 g/day.

The pregnancy category is B. The B category means that it has been studied in humans and that the beneficial effects far outweigh the deleterious effects. (The safest category is “A” which would mean that it is absolutely safe for pregnant women and will not effect their child at all – no drug carries this classification!)

The drug must be stopped if the pt develops persistent diarrhea, abdominal pain or bloody stool. The pseudomembranous symptoms usually begin after the pt has already stopped taking clindamycin.


AB-Induced Pseudomembraneous Enterocolitis is most often associated with the use of Clindamycin, but it does occur with the penicillins and Cephalosporins. Suspect this condition if pt develops severe diarrhea during or following AB therapy. Positive dx is confirmed by positive stool test for C. dificile.

Category: Pharmacology Notes