Clinamycin

Provider Level

RN/Paramedic

Class

Lincosamide antibiotic

Mechanism of Action

Reversibly binds to the 50S ribosomal subunit of susceptible bacteria, preventing peptide bond formation and inhibiting bacterial protein synthesis. It can be bacteriostatic or bactericidal depending on the concentration and the specific organism.

Indications

Treatment of severe infections caused by susceptible anaerobic bacteria, streptococci, pneumococci, and staphylococci. Often utilized in critical care transport for severe sepsis or open fractures, particularly in patients with severe penicillin allergies.

Contraindications

Hypersensitivity to clindamycin or lincomycin. History of regional enteritis, ulcerative colitis, or antibiotic-associated colitis.

Routes

PO, IM, IV, IO

Onset / Duration

Onset: Rapid for IV, 1 to 3 hours for PO and IM. Duration: 6 to 8 hours.

Adverse Effects

Diarrhea, nausea, vomiting, abdominal pain, rash, thrombophlebitis at the IV site, hypotension and even cardiac arrest if administered too rapidly intravenously. Risk of severe Clostridium difficile-associated diarrhea and pseudomembranous colitis.

Precautions & Interactions

Use with caution in patients with a history of gastrointestinal disease, severe renal or hepatic impairment, and highly atopic individuals. Monitor closely for signs of severe diarrhea.

Special Considerations

Must never be administered as an undiluted IV bolus; rapid administration can cause profound hypotension and cardiac arrest. It should be given as an intermittent infusion. It does not cross the blood-brain barrier adequately and is not used for meningitis.