Clindamycin: Uses, Treatments, and Information

Published August 2nd, 2021 by Nicole Salata, PharmD, MSHI
Fact Checked by
Chris Riley
Medically Reviewed:
Dr. Angel Rivera

Clindamycin is a Food & Drug Administration (FDA) approved drug that has a variety of uses across several ailments. Although it is a common treatment for acne, also called acne vulgaris, this product can also be used as a treatment for any number of bacterial infections. In combination with quinine, it can even be used to treat malaria. You can take clindamycin orally, as a pill or oral solution, as an injection, or as a cream, foam, or gel to be applied topically. But first, it is important to understand what clindamycin is and how it works so let's delve deeper to see if you should discuss using this treatment with your doctor or physician. 

What is Clindamycin?

Clindamycin is a lincosamide-type antibiotic, developed in 1966. This simply means that, as an antibiotic, it works most closely like lincomycin. In fact, clindamycin was made by making some small chemical changes to lincomycin, so they are very similar. 

Because it is most effective against anaerobic bacteria, or bacteria that do not require oxygen to thrive, it is most useful in treating infections in the head, neck, respiratory system, bones, soft tissue (muscle and skin), abdomen, and pelvis. However, clindamycin works against a large variety of pathogens. 

How does Clindamycin Work?

Most antibiotics work in one of two ways: they are bacteriostatic or bactericidal. 

Bactericidal antibiotics kill bacteria once they reach a necessary concentration, which is different for each antibiotic, the type of bacteria that needs to be killed, and the location of the infection. 

Bacteriostatic antibiotics, on the other hand, don’t directly kill the bacteria. Instead, they prevent the bacteria from being able to reproduce. Bacteria must rapidly grow and reproduce to establish and maintain an infection; so, if they can no longer reproduce, the infection will go away as the bacteria die naturally. However, in order to stop the infection, the antibiotic must still reach a necessary concentration. 

At lower concentrations, clindamycin is bacteriostatic. At higher concentrations, it is bactericidal. So, clindamycin is effective with many different types of bacteria depending on how it needs to work.

Another interesting fact about clindamycin is how long it works. Clindamycin displays what is called ‘post-antibiotic effect’. Most antibiotics stop working once they are no longer being taken; but if it has post-antibiotic effect, the medication continues to work even after it is no longer being used. The time period of post-antibiotic effect depends on the specific medication, the dose, and where it is being used; still, it continues to work for a period after it is stopped so that patients get a longer benefit from the medicine. 

What is Clindamycin Used For?

Now that it is clear what clindamycin is, and how it works, it is easier to understand what clindamycin can be used for. There are many, many uses for clindamycin, so each one will be discussed briefly. Most importantly, in the United States, clindamycin always requires a prescription from a doctor, nurse, or physician assistant, and may require some tests before it can be safely prescribed. Clindamycin is used against bacterial infections and should not be used to treat viral infections. 

Acne

Clindamycin is often used to treat acne, or more specifically, what is medically referred to as acne vulgaris. Acne not only occurs in adolescence, but also throughout adulthood in some people. Key features of acne are redness, acne lesions, and in worse cases, inflammation, which can lead to cystic lesions. Acne is typically found on the face, neck, chest, and back. 

Clindamycin fights acne in a few ways. First, as previously mentioned, it has bacteriostatic properties, preventing and treating infections in the skin that occur with acne, causing much of the swelling and inflammation in acne vulgaris. However, clindamycin has also been shown to alter the chemical makeup of the oils that skin secretes, making acne less likely. Put another way, your skin naturally secretes a greasy substance called sebum to keep your skin hydrated, soft, and strong. However, the different oils that makeup sebum vary from person to person depending on genes, diet, and other factors. Clindamycin affects sebum so that it is less likely to lead to acne. Finally, clindamycin has been shown to have anti-inflammatory properties in acne, reducing the swelling and inflammation associated with moderate and severe acne lesions.

Clindamycin for acne can be prescribed in two ways: topically, like gels, creams foams, serums, or lotions, to be applied directly in the area where acne is present; or, if acne is too widespread to have clindamycin applied everywhere, it is given orally in pill form. However, because of the risk of severe side effects from oral use, it is rarely used. Your doctor may also prescribe clindamycin to use in conjunction with other medications like benzoyl peroxide or salicylic acid. For alternative antibiotics used to treat acne, see the articles on Minocycline and Minocycline vs. Doxycycline

Allergies to Medication

For people who have allergies to penicillin and cephalosporins, two other common classes of antibiotics, clindamycin is often used as an alternative. This includes everything from preventing to treating specific infections; but the most common uses would be as a safe substitute in treating sinus infections, dental infections, ear infections, and some other types of skin infections. It is also used to prevent infection prior to dental surgery and general surgery, especially in the head or neck. 

Other Uses

Aside from acne and allergy-alternatives, clindamycin has many, many other possible uses. Briefly, as mentioned above, clindamycin can also be used in other types of bacterial infections like bone infections, abdominal infections, and vaginal infections.

Clindamycin is also indicated in some protozoal infections. Protozoa are microscopic parasites that cause illness in animals, including humans. Specifically, use of this medication in treating malaria, along with other medications, as well as others specific to patients with compromised immune systems. 

Side Effects

As with most prescription drugs, there is a risk of side effects you should be aware of before you start taking this medication. The most common possible side effects from taking a clindamycin injection or by taking it orally include:

  • vomiting
  • diarrhea 
  • rashes 
  • pain at the site of injection, if you are taking it intravenously 
  • Clostridium difficile colitis, a condition leading to watery diarrhea, fever, nausea, and abdominal pain

One of the biggest drawbacks of clindamycin is the fact that you are four times more likely to get Clostridium difficile colitis than other drugs. 

Should you experience any of these adverse effects while taking clindamycin orally or through an injection, please seek immediate medical attention. 

When taking clindamycin topically there are a different set of side effects that usually only affect the area of application. These adverse reactions include: 

  • dryness 
  • redness
  • itchiness 
  • scaliness 
  • burning 
  • peeling of skin
  • oiliness 
  • fungal infections, this is found in vaginal applications 

Most of the symptoms associated with taking clindamycin are usually mild but severe skin reactions and allergic reactions can occur. Should you experience any serious side effects please seek medical advice from your doctor immediately. 

It should also be stated here that the use of clindamycin by pregnant women is generally considered safe. When it comes to breastfeeding there is some debate. The American Academy of Pediatrics says that it is compatible to take this medication while breastfeeding; however, the World Health Organization, or WHO, recommends avoiding this medication if possible while breastfeeding. 

As always, please seek medical help from your doctor, healthcare provider, or pharmacist should you have any questions regarding taking clindamycin as a treatment or if you are experiencing any of the symptoms listed. 

How to Take Clindamycin

When taking this drug orally via capsules or tablets it is suggested to take it with a full glass of water. Clindamycin may also be taken with or without food, although taking it with food may slightly make your stomach less upset. 

When taking this drug topically, simply apply the solution to the affected area as prescribed by your doctor. 

For the best effect of potential benefits of the use of the medicine, please talk to your physician or pharmacist.

Summary

While clindamycin has a variety of uses and has been available for over 50 years, it is still one of the main antibiotics used for skin infections and acne. This is largely due to the fact that little antibiotic resistance has developed to clindamycin, so it remains very effective. 

Have more questions about what clindamycin is used for? Consult with your health care provider or check out these additional articles on Clindamycin in the read more articles listed below. 

References and Sources:

Algra RJ, Rosen T, Waisman M. Topical Clindamycin in Acne Vulgaris: Safety and Stability. Archives of Dermatology. 1977;113(10):1390-1391. doi:10.1001/archderm.1977.01640100068011

CUNLIFFE WJ, C'OTTERILL JA, WILLIAMSON B. THE EFFECT OF CLINDAMYCIN IN ACNE-A CLINICAL AND LABORATORY INVESTIGATION. British Journal of Dermatology. 1972;87(1):37-41. doi:https://doi.org/10.1111/j.1365-2133.1972.tb05095.x

Dawson AL, Dellavalle RP. Acne vulgaris. BMJ : British Medical Journal. 2013;346:f2634. doi:10.1136/bmj.f2634

Dhawan VK, Thadepalli H. Clindamycin: A Review of Fifteen Years of Experience. Reviews of Infectious Diseases. 1982;4(6):1133-1153. doi:10.1093/clinids/4.6.1133

Fletcher SM, Stark D, Harkness J, Ellis J. Enteric Protozoa in the Developed World: a Public Health Perspective. Clinical Microbiology Reviews. 2012;25(3):420-449.  doi:doi:10.1128/CMR.05038-11

Frankel RI. Clindamycin--efficacy and toxicity. The Western journal of medicine. 1975;122(6):526-530.

Murphy PB, Bistas KG, Le JK. Clindamycin. StatPearls Publishing, Treasure Island (FL); 2020.

Smieja M. Current Indications for the Use of Clindamycin: A Critical Review. Canadian Journal of Infectious Diseases. 1900/01/01 1998;9:538090. doi:10.1155/1998/538090

Spížek J, Řezanka T. Lincomycin, clindamycin and their applications. Applied Microbiology and Biotechnology. 2004/05/01 2004;64(4):455-464. doi:10.1007/s00253-003-1545-7

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