What is the role of clindamycin (Cleocin) in intravenous-to-oral switch therapy?

Updated: Jul 30, 2018
  • Author: Shirin A Mazumder, MD, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Answer

Other antibiotics that can be used for switch therapy include clindamycin, ertapenem, linezolid, metronidazole, and trimethoprim-sulfamethoxazole.

Clindamycin

Martinez and associates found that switch therapy can be used when administering clindamycin. [37] Specifically, a multicenter, prospective, controlled study compared the clinical efficacy, safety, and economic impact of pharmacist intervention to promote sequential IV-to-PO clindamycin conversion. Clindamycin was prescribed for respiratory tract infections in 38.9% of patients and for prophylaxis in surgery in 25.4% (71% were contaminated during surgery). A total of 473 patients receiving intravenous clindamycin for at least 72 hours were included in the study. Two groups were established. Those in the intervention group (204 patients) were given an informative sheet recommending the sequential treatment, and the other group consisted of 269 control patients. Outcomes appeared similar.

Clindamycin (Cleocin) is a lincosamide used to treat serious skin and soft tissue staphylococcal infections. It is also effective against aerobic and anaerobic streptococci (except enterococci). It inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest. In adults, dosing is (1) 150-450 mg/dose PO q6-8h, not to exceed 1.8 g/d, or (2) 600-1200 mg/d IV/IM divided q6-8h, depending on the severity of infection. In children, dosing is 8-20 mg/kg/d PO as hydrochloride or 8-25 mg/kg/d as palmitate divided tid/qid. Alternatively, use 20-40 mg/kg/d IV/IM divided tid/qid. Clindamycin is a pregnancy category C medication.


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