Clindamycin therapy has been associated with severe colitis which may end fatally.
It should be reserved for serious infections where less toxic antimicrobial agents are inappropriate.
It should not be used in patients with nonbacterial infections, such as most upper respiratory tract infections.
Its use in newborns is contraindicated.
Since clindamycin does not diffuse adequately into cerebrospinal fluid, the drug should not be used in the treatment of meningitis.
If therapy is prolonged, liver and kidney function tests should be performed.
The use of clindamycin phosphate may result in overgrowth of non-susceptible organisms, particularly yeasts.
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C.difficile.
C.difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C.difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
Clindamycin phosphate should not be injected intravenously undiluted as a bolus, but should be infused over at least 10-60 minutes as directed.
Effects on ability to drive and use machines: The effect of clindamycin on the ability to drive or operate machinery has not been systematically evaluated.