Clindamycin cream is indicated for the treatment of bacterial vaginosis. It may be used in non-pregnant women as well as in pregnant women during the second and third trimesters.

Clindamycin phosphate is a water-soluble ester derived from the parent antibiotic lincomycin. Clindamycin works by inhibiting bacterial protein synthesis through binding primarily to the 50S ribosomal subunit, thereby interfering with the initiation of the peptide chain. In vitro, clindamycin is active against most strains of the following organisms associated with bacterial vaginosis:

• Bacteroides species
• Gardnerella vaginalis
• Mobiluncus species
• Mycoplasma hominis
• Peptostreptococcus species

One applicator full (approximately 5 gram) intravaginally at bedtime for 7 consecutive days. In patients in whom a shorter treatment course is desirable, a 3-day regimen has been shown to be effective.

Clindamycin cream is not recommended for children under 12 years of age.

Clindamycin may cause a range of side effects affecting different systems: Genital tract: vaginitis, vulvovaginal irritation Central nervous system: dizziness, headache, vertigo Gastrointestinal: heartburn, nausea, vomiting, diarrhea, constipation, abdominal pain Dermatological: rash, exanthema Hypersensitivity reactions: urticaria

There are no adequate and well-controlled studies on the use of clindamycin cream during the first trimester of pregnancy. Therefore, it should be used during this period only if clearly needed. There is no restriction on the use of clindamycin cream during the second and third trimesters of pregnancy. It is not known whether clindamycin is excreted in breast milk following vaginal administration of clindamycin phosphate. However, clindamycin given by the oral or parenteral route has been reported to appear in breast milk.

Patients should be advised not to engage in vaginal intercourse and not to use other vaginal products during treatment with this cream. This product contains mineral oil, which may weaken latex or rubber products such as condoms or vaginal contraceptive diaphragms. Therefore, the use of such products is not recommended during treatment and within 72 hours after using clindamycin cream.

Overdose by intravaginal use is unlikely. However, accidental ingestion of the product may produce effects similar to those associated with therapeutic doses of oral clindamycin.

Macrolides

Store the tube below 25°C, away from light and moisture. Keep out of the reach of children.