Clindamycin: Antibiotic for Treating Bacterial Infections - Essay Sample

Introduction

Clindamycin is an antibiotic drug that is used to treat bacterial infections including infections of the skin, lungs, female reproductive organs, blood, and internal organs. The drug comes in topical, oral, and injectable forms. It belongs in the lincosamide family and works by disrupting the manner in which bacteria produce proteins ("Medical News Today," 2019). Depending on the type of infection and dosage, administration of clindamycin drug can either kill or stop bacterial growth. Clindamycin is used in the treatment of serious infections that are caused by susceptible anaerobic bacteria ("Mayo Clinic," 2019). It is also indicated in the treatment of serious infections that result from susceptible strains of streptococci, staphylococci, and pneumococci. Its use is reserved for penicillin-allergic patients or other patients whose use of penicillin is an inappropriate decision from a physician's perspective. The drug is available as the brand-name drug Cleocin and is also available as a generic drug ("Healthline"). It is also available as a topical foam, oral solution, topical gel, topical swab, topical lotion, topical solution, vaginal cream, and vaginal suppository. It is available as an intravenous 4 drug that is only given by a healthcare provider.

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Ingredients in the Drug

Clindamycin HCL refers to the hydrated hydrochloride salt of clindamycin. It is a semisynthetic antibiotic that is produced by the 7 (S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound (lincomycin). The Clindamycin hydrochloride capsules, USP contain clindamycin hydrochloride, USP equivalent to 150 mg of clindamycin.

It also contains inactive ingredients: 150mg- corn starch, black iron oxide, D&C Yellow ~10, gelatin, FD&C Blue no.1, lactose, magnesium stearate, monohydrate, propylene glycol, potassium hydroxide, talc, shellac, and titanium dioxide.

Structural Formula

The structural formula of clindamycin is represented below.

Its condensed formula is written as C18H33ClN2O5SHCl M.W. 461.45

Moreover, its chemical name is Methyl 7-chloro-6,7,8-trideoxy-6-(1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L-threo-a-D-galacto-octopyranoside monohydrochloride.

Used Forms

There are four forms in which clindamycin is used, i.e., injectable, oral, intravaginal, and tropical. The following indicates the forms of clindamycin, along with their dosages in milligrams (mg), milligrams per milliliter (mg/ml), or percentage.

Form Example

• Injection Clindamycin phosphate injection 6 mg/ml
• Clindamycin phosphate injection 12 mg/ml
• Clindamycin phosphate injection 18 mg/ml
• Clindamycin phosphate injection 150 mg/ml
• Intravaginal Cleocin cream 2%
• Cleocin suppository 100 mg
• Oral Clindamycin capsule 75 mg
• Clindamycin capsule 150 mg
• Clindamycin capsule 300 mg
• Clindamycin palmitate hydrochloride granules 75 mg/5 ml
• Tropical Evoclin foam 1%
• Clindagel 1%
• Cleocin T lotion 10 mg/ml
• Clindamycin phosphate solution 1%
• The form and dosage of clindamycin prescribed by a doctor depending on the kind of infection. According to "Healthline" (2019), the dosage, drug form, and frequency of the drug will depend on the patient's age, condition being treated, severity of the condition, reaction to the first dose, and other medical conditions.

Short Chemistry-Related Information

Clindamycin Side Effects

Clindamycin drug is used to treat certain types of bacterial infection, including lung, blood, and skin infections including those of the female reproductive and internal organs. It belongs to a class of medications referred to as lincomycin antibiotics that work by slowing down or stopping the growth of bacteria. However, the drugs come with various side effects discussed below.

The most common side effect of most of the antibiotics is diarrhea ("Medical News Today," 2019). The effect is sometimes felt when taking clindamycin. According to "Medical News Today," clindamycin can alter the composition of bacteria in the colon and result in an overgrowth in the Clostridium difficile (C. difficile) bacterium. The bacterium produces contaminants that cause C. difficile that contributes highly to diarrhea (CDAD) which is a life-threatening infection. A doctor would be forced to immediately stop clindamycin when a patient develops CDAD ("Mayo Clinic," 2019).

Other possible side effects of injectable or oral clindamycin include esophageal irritation, abdominal pain, nausea, allergic skin reactions, vomiting, vaginal inflammation, severe allergic reactions, a build-up of fluids under the skin, impeded liver and kidney functions, arthritis, blood disorders and disrupted functions of the immune systems. People that use clindamycin lotion or solution for acne also report skin-related side effects that include redness, dryness, peeling, oiliness, itchiness, and a stinging or burning sensation ("Mayo Clinic," 2019). Vaginal cream and clindamycin suppositories may result in equal side effects to the oral and injectable forms. Other side effects of using vaginal cream or clindamycin suppositories include vaginal fungal infections, vulva or vaginal disorders, inflammation of the vulva or vagina and vaginal pain ("Mayo Clinic," 2019).

Other observed reactions reported with the use of clindamycin include:

• Infections and infestations through clostridum difficile colitis.
• Jaundice and abnormalities in the functions of the liver during clindamycin therapy.
• Renal dysfunction has been evidenced by oliguria, azotemia, and proteinuria.
• Drug reactions with eosinophilia and cases of systemic symptoms (DRESS) (Murphy & Le, 2019).

The adverse effects of clindamycin depend on how the drug is administered. According to Murphy & Le (2019), the severe cases result from hypertoxic-producing strains that cause morbidity and mortality that requires proper medical attention. Other adverse effects include metallic taste with 4 administration (thrombophlebitis), agranulocytosis, abscess formation, anaphylactic shock, irritation from IM injection, and induration.

Dosage

Clindamycin is taken in form of capsules, vaginal cream and suppositories, and injection.

Capsules

For adults, the dosages of clindamycin capsules include the following:

• 150-300 mg every 6 hours for serious infections.
• 300-450 mg every 6 hours for more severe infections ("Medical News Today," 2019).

For children who can swallow capsules, the dosages are:

• 8-16 milligrams per kilogram (mg/kg) daily, split into three or four equal doses.
• 16-20 mg/kg daily for more severe infections, split into three or four equal doses ("Medical News Today," 2019).
• In the case of patients who experience difficulty in swallowing, clindamycin can be taken in the form of granules that can easily dissolve in water.

Vaginal Cream and Suppositories

These are used in the treatment of bacterial infections in the vagina. The cream is accompanied by an applicator. The amount of one applicator, approximately 100 mg of clindamycin is inserted into the vagina once on a daily basis during bedtime for three to seven nights consecutively ("Medical News Today," 2019).

In the case of a suppository, one suppository pill (approximately 100 mg of clindamycin) is inserted into the vagina once on a daily basis during bedtime for three nights consecutively.

Lotion, Gel, and Solution

Clindamycin lotion, gel, and solution are prescribed to treat acne. For its dosage a person with acne:

Applies a thin layer of clindamycin 1% solution or Cleocin T 1% lotion to the affected parts of the skin twice per day.

Applies Clindagel 1% once daily to the affected regions as soon as it appears (Medical News Today," 2019).

Injections

Injections are used when a person has a serious infection and are unable to take other antibiotics. The dosages of injectable clindamycin in mg/kg on a daily basis is presented below.

Person's Age Dosage in Injection

• Babies (less than 1 month old) 15-20 mg/kg per day in 3 to 4 equal doses.
• Children and adolescents (ages 1 month to 16 years) 20-40 mg/kg per day in 3 to 4 equal doses.
• People older than 16 years 600-1,200 mg/day in 2, 3, or 4 equal doses.
• More severe infections: 1,200-2,700 mg per day in 2, 3, or 4 equal doses.
• Life-threatening infections: up to 4,800 mg per day.

If a person misses a dose or doesn't take the drug on schedule, the medication may not work well or may stop working completely ("WebMD," 2019). Therefore, for this drug to work appropriately, specific amounts have to be taken at all times.

In the event of an overdose, various symptoms may be felt by the person. These include diarrhea, low blood pressure, temporary paralysis (limited ability to move), and convulsions (sudden movements that result from the tightening of muscles) ("WebMD," 2019).

Precautions

Clindamycin has neuromuscular blocking properties that improve the action of other neuromuscular blocking agents. The drug should, therefore, be used with caution for patients that receive such agents. Cleocin HCL should be prescribed with caution for individuals with a history of gastrointestinal disease, especially colitis. It should be prescribed with caution for atopic individuals. It should also not be used with CYP3A4 inducers, i.e., rifampin since they reduce how clindamycin works in the body. Antibacterial drugs, i.e., Cleocin HCL should only be used to treat bacterial infections.

References

"Healthline," (2019). Clindamycin: Side Effects, Dosage, Uses, and More. Healthline. Retrieved from https://www.healthline.com/health/clindamycin-oral-capsule

"Mayo Clinic," (2019). Clindamycin (Oral Route) Proper Use - Mayo Clinic. Mayoclinic.org. Retrieved from https://www.mayoclinic.org/drugs-supplements/clindamycin-oral-route/proper-use/drg-20110243

"Medical News Today," (2019). What is clindamycin? Uses, dosage, warnings, and side effects. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/325326.php

Murphy, P., & Le, J. (2019). Clindamycin. Statpearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519574/

Vardanyan, R. and Hruby, V.J. (2006). Clindamycin - an overview: Antibiotics-ScienceDirect Topics. Sciencedirect.com. Retrieved from https://www.sciencedirect.com/topics/chemistry/clindamycin

"WebMD," (2019). Drugs & Medications: Clindamycin HCL. Webmd.com. Retrieved from https://www.webmd.com/drugs/2/drug-12235/clindamycin-hcl-oral/details#