Clindamycin in the treatment of obstetric and gynecologic infections: a review

Abstract

The spectrum of clindamycin's activity includes anaerobes and gram-positive aerobes other than enterococci. No inactivation or incompatibility of clindamycin phosphate has been shown in intravenous solutions usually used clinically. After oral administration, clindamycin is almost completely absorbed, with mean peak serum levels reached in 45 to 60 minutes. Clindamycin is widely distributed in many body fluids and tissues. Its normal half-life is two to three hours, and thus it can be given at six-hour intervals. Because of its excellent coverage against anaerobes, gram-positive cocci, and Chlamydia trachomatis, clindamycin is the preferred antimicrobial agent for serious infections of the female genital tract. Clindamycin plus tobramycin or an aminoglycoside is effective treatment for pelvic inflammatory disease, particularly when a tubo-ovarian abscess is present. In post-cesarean section endometritis, clindamycin plus gentamicin has been shown to be more effective than any other treatment. Clindamycin (alone or with an aminoglycoside) has been used successfully in posthysterectomy vaginal cuff infections and, with an aminoglycoside, in septic abortions. Clindamycin has been well tolerated in studies of animals and human subjects; its most significant side effects develop in the gastrointestinal system.