Clindamycin pharmacokinetics

Pharmacology Lincomycin and clindamycin, known collectively as lincosamides, bind exclusively to the 50 S subunit of bacterial ribosomes and suppress protein synthesis. Cross-resistance has been demonstrated between these 2 agents. Clindamycin is preferred because it is better absorbed and more potent. Pharmacokinetics Administration with food markedly impairs lincomycin (but not clindamycin) oral absorption. 

Many antimicrobial agents have similar pharmacokinetic properties when given orally or parenterally (ie, tetracyclines, trimethoprim-sulfamethoxazole, quinolones, chloramphenicol, metronidazole, clindamycin, rifampin, linezolid and fluconazole). In most cases, oral therapy with these drugs is equally effective, is less costly, and results in fewer complications than parenteral therapy. 

Albert KS, DeSante KA, Welch RD, DiSanto AR. Pharmacokinetic evaluation of a drug interaction between kaolin-pectin and clindamycin. J Pharm Sci 1978 67 1579-1582. 

Budsberg, S.C., Kemp, D.T. Wolski, N. (1992) Pharmacokinetics of clindamycin phosphate in dogs after single intravenous and intramuscular administrations. American Journal of Veterinary Research, 53, 2333-2336. 

A. Classification and Pharmacokinetics The lincosamides lincomycin and clindamycin inhibit bacterial protein synthesis via a mechanism similar to that of the macrolides, though they are not chemically related. Mechanisms of resistance include methylation of the binding site on the 50S ribosomal subunit and enzymatic inactivation. Cross-resistance between lincosamides and macrolides is common. Good tissue penetration occurs after oral absorption. The lincosamides are eliminated partly by metabolism and partly by biliary and renal excretion. 

There appear to be no clinically significant pharmacokinetic interactions between aztreonam and amikacin, cefradine, clindamycin, gentamicin, metronidazole or nafcillin. 

One study found that the pharmacokinetics of intravenous ciprofloxacin 200 mg were not affected by intravenous clindamycin 600 mg and there is evidence that combined use may possibly enhance the antibacterial activity, particularly against S. aureus and S. pneumoniae. However, another study found that the serum bactericidal activity of ciprofloxacin against S. aureus was completely antagonised by clindamycin, if the strains were susceptible to the latter. ... 

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