Pharmacotherapeutic group: Anti-infectives for systemic use, lincosamides. ATCvet code: QJ01FF01
Clindamycin is mainly a bacteriostatic antibiotic belonging to the group of lincosamides. Clindamycin is a chlorinated analogue of lincomycin. It works by inhibiting bacterial protein synthesis. The reversible coupling to the sub-unit 50-S bacterial ribosome inhibits translation of amino acids linked to the tRNA, thereby preventing elongation of the peptide chain. That is why the mode of action of clindamycin is predominantly bacteriostatic.
Clindamycin and lincomycin have cross-resistance, which is also common between erythromycin and other macrolides.
Acquired resistance can occur, by methylation of the ribosomal binding site via chromosomal mutation in Gram-positive organisms, or by plasmid-mediated mechanisms in Gram-negative organisms
Clindamycin is active in vitro against many Gram-positive bacteria, Gram-positive and Gram-negative anaerobic bacteria. Most aerobic Gram-negative bacteria are resistant to clindamycin.
“CLSI clindamycin veterinary breakpoints are available for dogs in Staphylococcus spp. and Streptococci-ß-haemolytic group in skin and soft tissue infections: S ≤0.5 μg/ml; I=1-2 μg/ml; R ≥ 4 μg/ml”. (CLSI July 2013).
The incidence of resistance to lincosamides in Staphylococcus spp. appears to be wide-ranging in Europe. Literature data (2016) report an incidence between 25 to 40%.
Clindamycin is almost completely absorbed after oral administration. After oral administration of 11 mg/kg, maximum plasma concentrations of 8 µg/ml are reached within one hour (without any influence of food ).
Clindamycin is widely distributed and may concentrate in some tissues.
Elimination half life of clindamycin is around 4 hours. Approximately 70% is excreted in faeces and 30% in the urine.
Clindamycin is approximately 93% bound to plasma proteins.