Clindamycin (Topical)

Pharmacologic Category

Antibiotic, Lincosamide; Topical Skin Product, Acne

Dosing: Adult

Acne: Topical:

Gel (Cleocin T, ClindaMax), pledget, lotion, solution: Apply a thin film twice daily

Gel (Clindagel), foam (Evoclin): Apply once daily

Bacterial vaginosis: Intravaginal:

Suppositories: Insert one suppository (100 mg clindamycin) daily into vagina at bedtime for 3 days

Cream:

Cleocin: One full applicator inserted intravaginally once daily before bedtime for 3 or 7 consecutive days in nonpregnant patients or for 7 consecutive days in pregnant patients

Clindesse: One full applicator inserted intravaginally as a single dose at anytime during the day in nonpregnant patients

Alternate dosing: Pregnant or non-pregnant patients: Intravaginal:

Cream (preferred): One full applicator (5 g) at bedtime for 7 days (CDC [Workowski 2015])

Suppository (alternative therapy): One suppository (100 mg) daily at bedtime for 3 days (CDC [Workowski 2015]

Hidradenitis suppurativa (off-label use): Topical: Solution: Apply to affected area twice daily (Jemec 2012)

Rosacea (off-label use): Topical: Lotion: Apply twice daily to the face (Wilkin 1993)

* See Dosage and Administration in AHFS Essentials for additional information.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Pediatric

Acne vulgaris: Note: Due to emerging resistance patterns, should not typically be used as monotherapy for the management of acne vulgaris (Eichenfield 2013; AAD [Zaenglein 2016])

Children ≥7 years and Adolescents: Limited data available in <12 years of age (Eichenfield 2013): Topical:

Gel (Clindagel), Foam (Evoclin): Apply to affected area once daily

Gel (Cleocin T), pledget, lotion, solution: Apply a thin film twice daily

Bacterial vaginosis: Limited data available: Adolescents: Intravaginal:

Cream 2%: Limited data available: One full applicator (5 g) inserted intravaginally at bedtime for 7 days (CDC [Workowski 2015]; Red Book [AAP 2015])

Suppository: Insert one ovule (100 mg clindamycin) intravaginally once daily at bedtime for 3 days

Dosing: Renal Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; however, no dosage adjustments are required with systemic clindamycin use.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling; however, no dosage adjustments are required with systemic clindamycin use; use caution with severe hepatic impairment.

Use: Labeled Indications

Acne vulgaris: Treatment of acne vulgaris (topical gel, topical lotion, topical solution)

Bacterial vaginosis: Treatment of bacterial vaginosis (vaginal cream, vaginal suppository)

* See Uses in AHFS Essentials for additional information.

Use: Off-Label: Adult

Hidradenitis suppurativaLevel of Evidence [C]

Data from a limited number of patients studied suggest that topical clindamycin may be beneficial for the treatment of hidradenitis suppurativa Ref. Additional data may be necessary to further define the role of topical clindamycin in this condition.

RosaceaLevel of Evidence [C]

Data from a small double-blind study in patients with rosacea and a major papulopustular component suggest that topical clindamycin may be effective for treatment of rosacea Ref. Access Full Off-Label Monograph

Level of Evidence Definitions

Level of Evidence Scale

Class and Related Monographs

Lincosamides

Clinical Practice Guidelines

Acne:

American Academy of Dermatology, "Guidelines of care for the management of acne vulgaris," May 2016

Sexually Transmitted Disease:

CDC, “Sexually Transmitted Diseases Treatment Guidelines,” June 2015.

Administration: Topical

Foam: Dispense directly into cap or onto a cool surface; do not dispense directly into hands or face (foam will melt on contact with warm skin). Wash skin with mild soap and allow to fully dry. Apply in small amounts to face using fingertips and gently massage into affected areas until foam disappears. Avoid contact with eyes, mouth, lips, mucous membranes, or broken skin.

Gel: Avoid contact with eyes.

Lotion: Shake well immediately before using.

Solution or pledget: Avoid contact with eyes, mouth or other mucous membranes; solution/pledget contains an alcohol base and if inadvertent contact with mucous membranes occurs, rinse with liberal amounts of water. Remove pledget from foil immediately before use; discard after single use. May use more than one pledget for each application to cover area.

Administration: Intravaginal

Cream: Insertion with the applicator should be as far as possible into the vagina without causing discomfort.

Suppository: The foil should be removed prior to use; if the applicator is used for insertion, it should be washed after each use.

Administration: Pediatric

Intravaginal: Do not use for topical therapy, instillation in the eye, or oral administration. Wash hands prior to use. Remove foil from suppository; place cream or suppository into applicator; insert applicator into vagina as far as possible without causing discomfort and expel suppository or cream. Remain lying down for 30 minutes following administration. Wash applicator with soap and water following suppository use; if administering the cream, use each disposable applicator only once.

Topical: For dermal topical use only. Do not use intravaginally, instill in the eye, or administer orally. Avoid contact with eyes, mouth, lips, mucous membranes, or broken skin.

Foam: Before applying foam, wash affected area with mild soap, then dry. Remove cap, hold can at an upright angle, and dispense foam directly into the cap or onto a cool surface; do not dispense foam directly onto hands or face (foam will melt on content with warm skin). If can is warm or foam is runny, run can under cold water. Use fingertips to pick up small amounts of foam and gently massage into affected area until foam disappears. Wash hands after applying. Avoid fire, flame, or smoking during or immediately following application.

Gel, pledget, solution: Solution/pledget contains an alcohol base and if inadvertent contact with mucous membranes occurs, rinse with liberal amounts of water. Remove pledget from foil immediately before use; discard after single use. May use more than one pledget for each application to cover area.

Lotion: Shake well immediately before use; apply topically.

Storage/Stability

Cream: Store at room temperature. Protect from freezing.

Foam: Store at room temperature of 20°C to 25°C (68°F to 77°F). Avoid fire, flame, or smoking during or immediately following application.

Gel: Store at room temperature.

Clindagel: Do not store in direct sunlight.

Lotion: Store at room temperature of 20°C to 25°C (68°F to 77°F). Protect from freezing.

Suppository: Store at room temperature of 25°C (77°F); excursions are permitted to 15°C to 30°C (59°F to 86°F). Avoid heat >30°C (86°F) and high humidity.

Pledget: Store at room temperature.

Topical solution: Store at room temperature of 20°C to 25°C (68°F to 77°F). Protect from freezing.

Medication Patient Education with HCAHPS Considerations

What is this drug used for?

All skin products:

• It is used to treat pimples (acne).

• It may be given to you for other reasons. Talk with the doctor.

All vaginal products:

• It is used to treat vaginal infections.

Frequently reported side effects of this drug

• Burning

• Itching

• Dry skin

• Redness

• Oily skin

• Back pain

• Constipation

• Headache

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

• Clostridioides (formerly Clostridium) difficile-associated diarrhea like abdominal pain or cramps, severe diarrhea or watery stools, or bloody stools.

• Urinary tract infection like blood in the urine, burning or painful urination, passing a lot of urine, fever, lower abdominal pain, or pelvic pain.

• Severe skin irritation

• Vaginal pain, itching, and discharge

• Severe vaginal irritation

• Signs of a significant reaction like wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Medication Safety Issues

Sound-alike/look-alike issues:

Contraindications

Hypersensitivity to clindamycin, lincomycin, or any component of the formulation; history of antibiotic-associated colitis, regional enteritis, ulcerative colitis.

Warnings/Precautions

Concerns related to adverse effects:

• Colitis: Use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD); CDAD has been observed >2 months postantibiotic treatment. Discontinue drug if significant diarrhea, abdominal cramps, or passage of blood and mucus occurs.

Special populations:

• Atopic patients: Use with caution in atopic patients.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol with caution in neonates. See manufacturer’s labeling.

• Topical foam: Topical foam may cause irritation especially when used with abrasive, desquamating or peeling agents; avoid contact with eyes, mouth, lips, mucous membranes, or broken skin.

• Topical pledget or solution: Topical pledget and topical solution contain an alcohol base and may cause eye irritation or burning. Rinse with cool tap water if product comes in contact with mucous membranes, abraded skin, or eyes. Use caution when applying near mouth (unpleasant taste).

• Vaginal products: May weaken condoms, or contraceptive diaphragms; barrier contraceptives are not recommended concurrently or for 3-5 days (depending on the product) following treatment. Vaginal cream contains ingredients that may cause eye burning and irritation; rinse with cool tap water if product comes in contact with the eyes.

Other warnings/precautions:

• Appropriate use: Acne: American Academy of Dermatology (AAD) acne guidelines recommend clindamycin (topical) be used in conjunction with other therapies (not as monotherapy) due to the risk of bacterial resistance. If given for mild acne, clindamycin (topical) should be used in combination with benzoyl peroxide. If given for moderate to severe acne, it should be used in combination with a topical retinoid or systemic antibiotic agent (AAD [Zaenglein 2016]).

* See Cautions in AHFS Essentials for additional information.

Geriatric Considerations

This formulation has not been studied in a sufficient number of elderly patients to draw conclusions.

Warnings: Additional Pediatric Considerations

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures and respiratory depression; use caution (AAP 1997; Shehab 2009).

Pregnancy Considerations

Clindamycin crosses the placenta following oral and parenteral dosing (Philipson 1973; Weinstein 1976). The amount of clindamycin available systemically is less following topical and vaginal application than with IV or oral administration.

Various clindamycin vaginal products are available for the treatment of bacterial vaginosis. Recommendations for use in pregnant woman vary by product labeling. Current guidelines note that the same oral or vaginal regimens used in nonpregnant women may be used during pregnancy, including oral or vaginal clindamycin (CDC [Workowski 2015]).

If treatment for acne is needed during pregnancy, topical clindamycin may be considered if an antibiotic is needed. To decrease systemic exposure, pregnant women should avoid application to inflamed skin for long periods of time, or to large body surface areas (Kong 2013).

Breast-Feeding Considerations

It is not known if clindamycin is present in breast milk following vaginal or topical administration; clindamycin is present in breast milk following oral and IV dosing. Systemic clindamycin concentrations are less following topical and vaginal application. This minimal absorption should minimize potential exposure to a breastfeeding infant.

In general, antibiotics that are present in breast milk may cause nondose-related modification of bowel flora. Monitor breastfeeding infants for GI disturbances, diarrhea, and bloody stools if maternal treatment is required (WHO 2002).

Regarding vaginal or topical administration, the manufacturer states that the decision to continue or discontinue breastfeeding during therapy should take into account the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

If clindamycin is used topically to the chest for the treatment of acne in females who are breastfeeding, care should be taken to avoid accidental ingestion by the infant. To decrease systemic exposure, breastfeeding females should avoid application to inflamed skin for long periods of time, or to large body surface areas (Kong 2013).

Lexicomp Pregnancy & Lactation, In-Depth

• Clindamycin (Topical)

Briggs' Drugs in Pregnancy & Lactation

• Clindamycin

Adverse Reactions

Topical: >10%: Dermatologic: Xeroderma (18% to 23%; gel, lotion, solution), oily skin (gel, lotion: 10% to 18%; solution: 1%), erythema (7% to 16%; gel, lotion, solution), burning sensation of skin (10% to 11%; gel, lotion, solution), exfoliation of skin (7% to 11%; lotion, solution), pruritus (7% to 11%; gel, lotion, solution)

Vaginal:

>10%: Genitourinary: Vaginal moniliasis (≤13%)

1% to 10%:

Dermatologic: Pruritus (≤1% nonapplication site; <1% application site)

Genitourinary: Vulvovaginal disease (3% to 9%), vulvovaginitis (≤7%), vaginal pain (2%), trichomonal vaginitis (≤1%)

Infection: Fungal infection (≤1%)

<1%, postmarketing, and/or case reports (all routes): Abdominal cramps, abdominal pain, application site pain, bacterial infection, bloody diarrhea, colitis, constipation, contact dermatitis, diarrhea (hemorrhagic or severe), dizziness, dysgeusia, dyspepsia, dysuria, edema, endometriosis, epistaxis, erythema, eye pain, fever, flank pain, flatulence, folliculitis, folliculitis (gram-negative infection), gastrointestinal disease, gastrointestinal distress, halitosis, headache, hypersensitivity reaction, hyperthyroidism, maculopapular rash, menstrual disease, nausea, pain, pseudomembranous colitis, pyelonephritis, severe colitis, skin rash, upper respiratory infection, urinary tract infection, urticaria, uterine hemorrhage, vaginal discharge, vertigo, vomiting, vulvovaginal pruritus

* See Cautions in AHFS Essentials for additional information.

Allergy and Idiosyncratic Reactions

• Lincosamide Allergy

Metabolism/Transport Effects

None known.

Drug Interactions Open Interactions

Erythromycin (Systemic): May diminish the therapeutic effect of Clindamycin (Topical). Risk X: Avoid combination

Erythromycin (Topical): May diminish the therapeutic effect of Clindamycin (Topical). Risk X: Avoid combination

Neuromuscular-Blocking Agents: Clindamycin (Topical) may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk C: Monitor therapy

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Cream, Vaginal, as phosphate [strength expressed as base]:

Cleocin: 2% (40 g) [contains benzyl alcohol]

Clindesse: 2% (5 g) [contains disodium edta, methylparaben, propylparaben]

Generic: 2% (40 g)

Foam, External, as phosphate [strength expressed as base]:

Evoclin: 1% (50 g, 100 g) [contains alcohol, usp, cetyl alcohol, propylene glycol]

Evoclin: 1% (50 g [DSC], 100 g [DSC]) [contains cetyl alcohol, propylene glycol]

Generic: 1% (50 g, 100 g)

Gel, External, as phosphate [strength expressed as base]:

Cleocin-T: 1% (30 g, 60 g) [contains methylparaben, propylene glycol]

Clindagel: 1% (75 mL) [contains methylparaben, polyethylene glycol, propylene glycol]

Generic: 1% (30 g, 60 g, 75 mL)

Kit, External, as phosphate [strength expressed as base]:

Clindacin ETZ: 1% [contains cetyl alcohol, isopropyl alcohol, propylene glycol]

Clindacin Pac: 1% [contains cetyl alcohol, isopropyl alcohol, propylene glycol]

Lotion, External, as phosphate [strength expressed as base]:

Cleocin-T: 1% (60 mL) [contains cetostearyl alcohol, methylparaben]

Generic: 1% (60 mL)

Solution, External, as phosphate [strength expressed as base]:

Cleocin-T: 1% (30 mL [DSC], 60 mL [DSC]) [contains isopropyl alcohol, propylene glycol]

Generic: 1% (30 mL, 60 mL)

Suppository, Vaginal, as phosphate [strength expressed as base]:

Cleocin: 100 mg (3 ea)

Swab, External, as phosphate [strength expressed as base]:

Cleocin-T: 1% (60 ea) [contains isopropyl alcohol, propylene glycol]

Clindacin ETZ: 1% (60 ea) [contains isopropyl alcohol, propylene glycol]

Clindacin-P: 1% (69 ea) [contains isopropyl alcohol, propylene glycol]

Generic: 1% (60 ea)

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Cream, Vaginal, as phosphate [strength expressed as base]:

Dalacin Vaginal: 2% (40 g) [contains benzyl alcohol, propylene glycol]

Solution, External, as phosphate [strength expressed as base]:

Clinda-T: 1% (30 mL, 60 mL) [contains isopropyl alcohol, propylene glycol]

Dalacin T: 1% (30 ea, 60 ea) [contains alcohol, usp, propylene glycol]

Generic: 1% (30 mL, 60 mL)

Swab, External, as phosphate [strength expressed as base]:

Clindets: 1% ([DSC])

Anatomic Therapeutic Chemical (ATC) Classification

• D10AF01

Generic Available (US)

May be product dependent

Pricing: US

Cream (Cleocin Vaginal)

2% (per gram): $5.77

Cream (Clindamycin Phosphate Vaginal)

2% (per gram): $2.72 - $3.26

Cream (Clindesse Vaginal)

2% (per gram): $29.23

Foam (Clindamycin Phosphate External)

1% (per gram): $6.93

Foam (Evoclin External)

1% (per gram): $11.44

Gel (Cleocin-T External)

1% (per gram): $3.68

Gel (Clindagel External)

1% (per mL): $28.44

Gel (Clindamycin Phosphate External)

1% (per gram): $2.88 - $3.46

Kit (Clindacin ETZ External)

1% (per each): $729.53

Kit (Clindacin Pac External)

1% (per each): $729.53

Lotion (Cleocin-T External)

1% (per mL): $2.31

Lotion (Clindamycin Phosphate External)

1% (per mL): $2.00 - $2.40

Solution (Clindamycin Phosphate External)

1% (per mL): $0.96 - $1.36

Suppository (Cleocin Vaginal)

100 mg (per each): $70.32

Swab (Clindacin ETZ External)

1% (per each): $12.16

Swab (Clindacin-P External)

1% (per each): $10.57

Swab (Clindamycin Phosphate External)

1% (per each): $0.84

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Mechanism of Action

Reversibly binds to 50S ribosomal subunits preventing peptide bond formation thus inhibiting bacterial protein synthesis; bacteriostatic or bactericidal depending on drug concentration, infection site, and organism

Pharmacodynamics/Kinetics

Absorption: Topical solution or foam, phosphate: Minimal; Vaginal cream, phosphate: ~5%; Vaginal suppository, phosphate: ~30%

Metabolism: Hepatic; forms metabolites (variable activity); Clindamycin phosphate is converted to clindamycin HCl (active)

Half-life elimination: Vaginal cream: 1.5 to 2.6 hours following repeated dosing; Vaginal suppository: 11 hours (range: 4 to 35 hours, limited by absorption rate)

Time to peak, serum: Vaginal cream: ~10 to 14 hours (range: 4 to 24 hours); Vaginal suppository: ~5 hours (range: 1 to 10 hours)

Excretion: Urine (<0.2% with topical foam and solution)

Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions

Effects on Dental Treatment

No significant effects or complications reported

Effects on Bleeding

No information available to require special precautions

Index Terms

Clindamycin Phosphate

FDA Approval Date

February 22, 1970

References

Ahlfors CE. Benzyl alcohol, kernicterus, and unbound bilirubin. J Pediatr. 2001;139(2):317-319.[PubMed 11487763]

American Academy of Pediatrics (AAP). In: Kimberlin DW, Brady MT, Jackson MA, Long SA, eds. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015.

Barza M, Goldstein JA, Kane A, et al, “Systemic Absorption of Clindamycin Hydrochloride After Topical Application,” J Am Acad Dermatol, 1982, 7(2):208-14.[PubMed 6215432]

Centers for Disease Control (CDC). Neonatal deaths associated with use of benzyl alcohol—United States. MMWR Morb Mortal Wkly Rep. 1982;31(22):290-291. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001109.htm[PubMed 6810084]

Clemmensen OJ. Topical treatment of hidradenitis suppurativa with clindamycin. Int J Dermatol. 1983;22(5):325-328.[PubMed 6347922]

Cleocin T topical gel, lotion, and solution (clindamycin) [prescribing information]. New York, NY: Pharmacia & Upjohn Co; December 2019.

Cleocin T topical solution (clindamycin) [prescribing information]. New York, NY: Pharmacia & Upjohn; November 2017.

Cleocin vaginal cream (clindamycin) [prescribing information]. New York, NY: Pharmacia & Upjohn; May 2019.

Cleocin vaginal suppository (clindamycin) [prescribing information]. New York, NY: Pharmacia & Upjohn; October 2019.

Clindagel (clindamycin) [prescribing information]. Bridgewater, NJ: Valeant Pharmaceuticals; November 2017.

Clindesse vaginal cream (clindamycin) [prescribing information]. Allegan, MI: Perrigo; November 2014.

Clindets pledgets (clindamycin solution) [product monograph]. Mississauga, Ontario, Canada: GlaxoSmithKline Inc; October 2016.

Eichenfield LF, Krakowski AC, Piggott C, et al. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics. 2013;131 Suppl 3:S163-186.[PubMed 23637225]

Evlocin (clindamycin foam) [prescribing information]. Morgantown, WV: Mylan Pharmaceuticals; April 2018.

Falagas ME and Gorbach SL, “Clindamycin and Metronidazole,” Med Clin North Am, 1995, 79(4):845-67.[PubMed 7791427]

"Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics (AAP) Committee on Drugs. Pediatrics. 1997;99(2):268-278.[PubMed 9024461]

Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med. 2012;366(2):158-164.[PubMed 22236226]

Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013;73(8):779-787.[PubMed 23657872 ]

Philipson A, Sabath LD, and Charles D, "Transplacental Passage of Erythromycin and Clindamycin," N Engl J Med, 1973, 288(23):1219-21.[PubMed 4700555]

Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259.[PubMed 19188870]

Smilack JD, Wilson WR, and Cockerill FR 3d, “Tetracyclines, Chloramphenicol, Erythromycin, Clindamycin, and Metronidazole,” Mayo Clin Proc, 1991, 66(12):1270-80.[PubMed 1749296]

Weinstein AJ, Gibbs RS, and Gallagher M, "Placental Transfer of Clindamycin and Gentamicin in Term Pregnancy," Am J Obstet Gynecol, 1976, 124(7):688-91.[PubMed 943947]

Wilkin JK, DeWitt S. Treatment of rosacea: topical clindamycin versus oral tetracycline. Int J Dermatol. 1993;32(1):65-67.[PubMed 8425809]

Workowski KA, Bolan GA; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1-137.

World Health Organization (WHO). Breastfeeding and maternal medication, recommendations for drugs in the Eleventh WHO Model List of Essential Drugs. 2002. Available at http://www.who.int/maternal_child_adolescent/documents/55732/en/

Wynn RL and Bergman SA, “Antibiotics and Their Use in the Treatment of Orofacial Infections, Part I and Part II,” Gen Dent, 1994, 42(5):398-402, 498-502.[PubMed 7489869]

Wynn RL, “Clindamycin: An Often Forgotten but Important Antibiotic,” AGD Impact, 1994, 22:10.

Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.e33. http://www.jaad.org/article/S0190-9622(15)02614-6/pdf. Accessed June 13, 2016.[PubMed 26897386]

Brand Names: International

Acnegon (LK); Albiotin Acne (LK); Aledo Gel (TW); Avocin (KW, QA, SA); Butamycin-N (GR); Clearex (SY); Cleocin T (KR, TW); Cleocin-T (BB); Clicia Solution (KR); Clidacor Gel (ID); Clidan (UY); Clidets Gel (MX); Clinacin-T (EG); Clinagel (BR); Clindac-A (IN); Clindacin (AR, BD, RU); Clindacin T (AE); Clindagel (GR); Clindamycin-T (SA); Clindasol (EG, SA); ClindaTech (PH); Clindax Lotion (BD); Clinderm (PH); Clinex (BD); Cliniderm (LB); Clinika (ID); Clinimycin (KW, QA); Clinimycin T (LB); Clinimycin-T (SA); Clinocid (EG); Clintopic (UY); Clinwas (ES); Cutaclin (CR, DO, GT, HN, MX, NI, PA, PE, SV); Daclin (BD); Dalacin (BE, DK, ES, FI, HU, IS, LU, NO, SI); Dalacin al 1% (VE); Dalacin C Lotion (TR); Dalacin Lotion (AT); Dalacin Solution (AT); Dalacin T (AE, AU, BG, BH, BR, CH, CL, CN, CO, CZ, DK, EE, EG, GB, HK, IE, IT, JO, KW, LV, MT, MX, MY, NL, PE, PK, PL, PT, QA, SA, SG, SK, TH, UA, ZA, ZW); Dalacin T Gel (CR, DO, HN, NI, PA, SV); Dalacine (FR); Dalacine T (FR); Dalagis Foam (IL); Derma T (KW, QA); Derma-T (AE, SA); Dermabel (CL); Duoclin (KR); Edason Cutaneous (MT); Glencin T (AE); Klinna (TH); Kolincin (HK); Lindamax (BD); Medacin T (LB); Mediacin T (AE); Mediklin (ID); Rosil (TH); T3 Mycin Gel (VN); T3-Mycin (ET); T3Mycin (HK, PH, SG); Tidact Gel (MY); Topicil (SG); Zindaclin (BE, CZ, ES, GB, HK, IE, IL, LB, MY, PL, PT, TR); Zindacline (FR)

Last Updated 3/19/20