Clindamycin Cream

One application unit is equivalent to 5 g. This comprises 100 mg clotrimazole and 20 mg clindamycin. 

Add and dissolve remaining items in a separate blender and heat to 40°C. 

Add into step 2 with vigorous mixing to form a cream base. 

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Clindamycin vaginal cream is the preferred therapy for bacterial vaginosis during lactation because metronidazole is listed as a drug of concern by the American Academy of Pediatrics (AAP)14 (Tables 44—4 and 44—5). Counsel patients that clindamycin cream weakens latex condoms and diaphragms, potentially rendering them ineffective. 

Ahmed-Jushuf IH, Shahmanesh M, Arya OP The treatment of bacterial vaginosis with a 3-day course of 2% clindamycin cream Results of a multicenter, double-blind, placebo-controlled trial. Genitourin Med 1995 71 254— 266. 

In pregnant women with bacterial vaginosis, a 7-day regimen of 2% vaginal clindamycin cream was effective and did not alter the rates of preterm deliveries or peripartum infections (64,65). 

Clindamycin cream (2%) for the treatment of bacterial vaginosis caused vaginal discharge in 4.6% of patients and vulvovavginal pruritus in 8.5%. No serious adverse events were reported [90 ]. 

It is not a first-line agent owing to lower efficacy compared with oral metronidazole in non-pregnant populations.38 Avoid clindamycin vaginal cream due to associations with premature labor and neonatal infection.38... 

Intravaginal clindamycin 2% cream once daily for 7 days... 

Ferris DG, Litaker MS, Woodward L, Mathis D, Hendrich J Treatment ofbacterial vaginosis A comparison of oral metronidazole, metronidazole vaginal gel and clindamycin vaginal cream. J Fam Pract 1995 41 443-449. 

Levinson, R. S., Mitan, S. J., Steinmetz, J. I., Gattermeir, D. J., Schumacher, R. J., and Joffrion, J. L. (2005), An open-label, two-period, crossover study of the systemic bioavailability in healthy women of clindamycin phosphate from two vaginal cream formulations, Clin. Ther., 27,1894-1900. 

Borin, M. T. (1990), Systemic absorption of clindamycin following intravaginal application of clindamycin phosphate 1% cream,/. Clin. Pharmacol., 30, 33-38. 

Clindamycin also is indicated for the treatment of bacterial vaginosis Its efficacy as a 2% cream is similar to oral metronidazole treatment. Measurable... 

Fischbach, F. Petersen, E. Weissenbacher, E. Martins, J. Hosmann, J. Mayer, H. Efficacy of clindamycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis. Obstet. Gynecol. 1993, 82, 405-410. 

In a one-year retrospective study at a tertiary hospital in Spain, 17% of 148 episodes of diarrhea associated with C. difficile developed after therapy with clindamycin (26). The possible association of toxin-positive C. difficile-induced colitis and the use of clindamycin phosphate vaginal cream for bacterial vaginosis has been reported in a 25-year-old white woman postpartum (27). 

Clindamycin can rarely cause antibiotic-associated diarrhea after short-term use as vaginal cream (33). 

Whereas only about 4% of clindamycin from a vaginal cream was systemically absorbed, systemic absorption was in the range of 30% when clindamycin was intra-vaginally administered as a phosphate ovule (67). 

Meadoweroft AM, Diaz PR, Latham GS. Clostridium difficile toxin-induced colitis after use of clindamycin phosphate vaginal cream. Ann Pharmacother 1998 32(3) 309-11. 

Vermeulen GM, van Zwet AA, Bruinse HW. Changes in the vaginal flora after two percent clindamycin vaginal cream in women at high risk of spontaneous preterm birth. BJOG 2001 108(7) 697-700. 

Borin MT, Ryan KK, Hopkins NK. Systemic absorption of clindamycin after intravaginal administration of chndamycin phosphate ovule or cream. J Clin Pharmacol 1999 39(8) 805-10. 

Clindamycin phosphate is a water-soluble ester of the semisynthetic antibiotic produced by a 7(S)-chloro- substitution of the 7(R)-hydroxyl group of the parent antibiotic lincomycin. The chemical name for clindamycin phosphate is methyl 7-chloro-6,7,8-trideoxy-6-(l-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1 -thio-L-threo-(alpha)-D-galacto-octopyranoside 2-(dihydrogen phosphate). It has a molecular weight of 504.96, and the molecular formula is C 8HhCIN208. Vaginal cream, 2%,... 

Clindamycin also is available as a topical solution, gel, or lotion (cleocin t, others) and as a vaginal cream (cleocin). It is effective topically (or orally) for acne vulgaris and bacterial vaginosis. 

Anti-acne creams have been shown to cause systemic toxic effects. For example, retinoic acid is a known teratogen (Steele et al. 1983) and is found in certain formulations. Other formulations contain clindamycin, which is reviewed below. 

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