Is it Safe to Take Clindamycin in Pregnancy?

Clindamycin hydrochloride for injection is indicated for the following infectious diseases caused by Gram-positive bacteria: 1. Tonsillitis, suppurative otitis media, sinusitis, etc. 2. Acute bronchitis, acute exacerbation of chronic bronchitis, pneumonia, lung abscess, and bronchiectasis with infection. 3. Infection of skin and soft tissues; pimple, palate, abscess, cellulitis, trauma, burns, and surgical infections. 4. Urinary system infection, acute urethritis, acute pyelonephritis, prostatitis, etc. 5. Others: osteomyelitis, sepsis, peritonitis, and oral infections. Various infectious diseases caused by anaerobic bacteria: 1. Empyema, muscle abscess, anaerobic pneumonia. 2. Skin and soft tissue infections, sepsis. 3 Intraperitoneal infections: peritonitis, intra-abdominal abscess. 4 Female pelvic and genital infections: endometritis, non-gonococcal fallopian tubes and ovarian abscesses, pelvic cellulitis, and infections after gynecological surgery.

Drug Name: Clindamycin hydrochloride for injection

Drug type: Prescription medicines, essential medicines, medicines for medical workers' injuries
Use classification: Antibiotics

Clindamycin hydrochloride for injection

The main ingredient of this product is clindamycin hydrochloride.
Chemical name: 6- (1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido) -1-thio-7 (S) -chloro-6,7,8-trideoxy- L-threo-aD-galactopyranoside hydrochloride.
Chemical Structure:

Molecular formula: C ₁₈ H ₃₃ ClN ₂ O ₅ S · HCl
Molecular weight: 461.44

Clindamycin hydrochloride for injection

This product is white or almost white loose bulk.

Clindamycin hydrochloride for injection

The following infectious diseases caused by Gram-positive bacteria:
1. Tonsillitis, suppurative otitis media, sinusitis, etc.
2. Acute bronchitis, acute exacerbation of chronic bronchitis, pneumonia, lung abscess, and bronchiectasis with infection.
3. Infection of skin and soft tissues; pimple, palate, abscess, cellulitis, trauma, burns, and surgical infections.
4. Urinary system infection, acute urethritis, acute pyelonephritis, prostatitis, etc.
5. Others: osteomyelitis, sepsis, peritonitis, and oral infections.
Various infectious diseases caused by anaerobic bacteria:
1. Empyema, muscle abscess, anaerobic pneumonia.
2. Skin and soft tissue infections, sepsis.
3 Intraperitoneal infections: peritonitis, intra-abdominal abscess.
4 Female pelvic and genital infections: endometritis, non-gonococcal fallopian tubes and ovarian abscesses, pelvic cellulitis, and infections after gynecological surgery.

Clindamycin hydrochloride for injection

(1) 0.45g (calculated for C ₁₈ H ₃₃ ClN ₂ O ₅ S)
(2) 0.5g (calculated for C ₁₈ H ₃₃ ClN ₂ O ₅ S)
(3) 0.6g (calculated for C ₁₈ H ₃₃ ClN ₂ O ₅ S)
(4) 0.75g (calculated for C ₁₈ H ₃₃ ClN ₂ O ₅ S)
(5) 0.9g (calculated for C ₁₈ H ₃₃ ClN ₂ O ₅ S)

Clindamycin hydrochloride for injection

Adult: Deep intramuscular injection or intravenous drip.
Moderate infection: 0.6 to 1.2 g / day, divided into 2 to 3 times.
Severe infection: 1.2 to 2.7 g / day, divided into 2 to 3 times. Or as directed by your doctor.
Children: Moderate infection: intramuscular injection or intravenous drip: 15-25 mg / kg / day, divided into 2 or 3 times.
Severe infection: 25 40mg / kg / day, divided into 2 or 3 times or as directed by a doctor.
Intravenous infusion 0.3g of this product is diluted with 100ml physiological saline or 5% glucose solution, and intravenously infused for 30 minutes.

Side effects of clindamycin hydrochloride for injection

Foreign literature shows that the adverse reactions of clindamycin phosphate injection are as follows:
1. Gastrointestinal reactions: common nausea, vomiting, abdominal pain, diarrhea, etc .; severe cases include abdominal cramps, abdominal tenderness, severe diarrhea (watery or pus and bloody samples), fever, abnormal thirst, and fatigue (pseudomembrane enteritis). Diarrhea, enteritis, and pseudomembranous enteritis can occur early in the course of administration, or can occur several weeks after discontinuation.
2. Blood system: occasional leukopenia, neutropenia, eosinophilia, and thrombocytopenia; rare aplastic anemia.
3 Allergic reactions: visible rash, pruritus, etc., occasional urticaria, angioedema, and serum sickness, etc., rare exfoliative dermatitis, bullous dermatitis, erythema polymorphism, and Steven-Johnson syndrome.
4 Abnormal liver and kidney function, such as elevated serum aminotransferase and jaundice.
5. Intravenous drip may cause phlebitis; intramuscular injection may cause pain, induration and sterile abscesses.
6. Others: tinnitus, dizziness, candida infection, etc.
Adverse reactions of clindamycin phosphate and clindamycin hydrochloride injections in China have reported that the use of this product may cause renal damage and hematuria. There are also very few serious cases of adverse reactions including dyspnea, anaphylactic shock, acute kidney disease. Functional failure, allergic purpura, convulsions, abnormal liver function, chest tightness, palpitations, chills, high fever, dizziness, hypotension, tinnitus, hearing loss, etc.

Clindamycin hydrochloride for injection

This product has cross-resistance with lincomycin, and those with a history of allergies to this product or lincomycin are contraindicated.

Clindamycin hydrochloride for injection

1. This product has no cross-allergic reaction with penicillin and cephalosporin antibiotics, and can be used for those allergic to penicillin. Use with caution in those with a history of asthma or other allergies, which may cause exacerbations of asthma.
2. When using, please strictly observe the dosage and dosage of the drug instruction manual, pay attention to the infusion rate and divided administration. When the intravenous dose is too large, the infusion rate is too fast, and the concentration is too high, this product may cause renal function damage, hematuria, and severe cases may cause renal failure.
3 This product is compatible with ampicillin, phenytoin, barbiturate hydrochloride, aminophylline, calcium gluconate, and magnesium sulfate; it is antagonistic to erythromycin and should not be used in combination.
4 Patients with impaired liver and kidney function and children under 4 years of age should be used with caution. Pregnant women and lactating women should weigh the advantages and disadvantages when using this product.
5. If pseudomembranous enteritis occurs, choose vancomycin orally from 0.125 to 0.5 g, 4 times a day for treatment.
6. Animal muscle stimulation test results show that intramuscular injection of this product can cause severe hyperemia and muscle degeneration in the quadriceps of rabbits.

Clindamycin hydrochloride for pregnant and lactating women

The efficacy and safety of medication for pregnant women have not been established, and this product can be passed through the placenta, and pregnant women should be used with caution; this product can be secreted into breast milk, and used with caution by lactating women. When using this product, breastfeeding must be suspended.

Clindamycin hydrochloride for children

The effectiveness and safety of medication for children under 12 years have not been established.

Clindamycin hydrochloride for injection

The effectiveness and safety of medication for elderly patients over 65 years have not been established. Elderly people with severe basic diseases are prone to adverse reactions such as diarrhea or pseudomembranous enteritis, which should be closely observed when taking the drug.

Clindamycin Hydrochloride Drug Interactions for Injection

1. This product can enhance the neuromuscular blocking phenomenon of inhaled anesthetics, leading to skeletal muscle weakness and respiratory depression or paralysis (apnea). It should be used with caution during or after surgery. Treatment with anticholinyl esterase drugs or calcium salts is expected to be effective.
2. This product is used in combination with anti-peristaltic antidiarrheal medicines and anti-diarrheal medicines containing white clay, which may cause pseudomembranous enteritis with severe watery diarrhea during the course of treatment or even a few weeks after the course of treatment. Due to the delayed discharge of colon endotoxin, which leads to prolonged and exacerbated diarrhea, this product should not be used in combination with antiperistaltic antidiarrheal drugs. When combined with white clay-containing antidiarrheal medicine, the absorption of this product will be significantly reduced, so it is not advisable to take the two at the same time, it is necessary to take a certain time (at least 2 hours).
3. This product has a neuromuscular blocking effect, which can enhance the effect of neuromuscular blocking drugs. Avoid using them together. The combination of this product with anti-muscle weakness drugs will cause the latter's effect on skeletal muscles to weaken. To control the symptoms of myasthenia gravis, the dose of anti-muscle weakness drugs should be adjusted when combined.
4. Both chloramphenicol and erythromycin can replace this product on the target site, or inhibit the combination of this product with the bacterial ribosome 50S subunit. In vitro tests show that this product has antagonism with erythromycin, so this product Should not be combined with chloramphenicol or erythromycin.
5. When combined with opioid analgesics, the respiratory depression effect of this product and the central respiratory depression effect of opioids may be added to cause prolonged respiratory depression or cause respiratory paralysis (apnea). Perform close observation or monitoring.
6. This product should not be added to complex infusions to avoid compatibility contraindications.

Clindamycin Hydrochloride Overdose for Injection

Overdose of this product can cause systemic symptoms and supportive treatment for symptomatic symptoms. Hemodialysis and peritoneal dialysis cannot be effectively removed.

Clindamycin hydrochloride pharmacology and toxicology for injection

Pharmacological effects:
This product is a lincoamide antibiotic, which mainly inhibits the early protein synthesis of bacteria by binding to the 50S subunit bacterial ribosome, and removes the protein A and villous coat on the surface of the bacteria, making it easy to be swallowed and killed. In vitro tests have shown that clindamycin is active against the following microorganisms:
1. Aerobic Gram-positive cocci: Staphylococcus aureus and Staphylococcus epidermidis (both include penicillinase-producing and non-penicillinase-producing strains), Streptococcus (except Enterococcus faecalis), and Pneumococcus.
2. Anaerobic Gram-negative genus: Bacteroides (including B. fragile and B. melanogenesis) and Fusobacterium.
3 Anaerobic Gram-positive non-producing Bacillus: Propionibacterium, Eubacteria and Actinomycetes.
4 Anaerobic and microaerobic Gram-positive bacteria: Peptococcus, Microaerobic Streptococcus, and Peptostreptococcus.
Toxicology research:
Genotoxicity: Ames Salmonella reverse mutation test and rat micronucleus test results were negative.
Reproductive toxicity: The dose of this product is 300mg / kg given orally to rats. No effect on mating and fertility in animals has been seen. Rats and mice were orally given clindamycin at a dose of up to 600 mg / kg or subcutaneously at a dose of 250 mg / kg, with no teratogenic effects. However, sufficient and rigorous clinical studies have not been conducted on pregnant women. Animal reproduction studies cannot fully predict human response. This product can only be used during pregnancy if clearly needed.
Preparation safety test: The results of animal muscle irritation test show that this product can cause severe hyperemia and muscle degeneration in rabbit quadriceps after intramuscular injection.

Pharmacokinetics of Clindamycin Hydrochloride for Injection

Literature: The peak time (Tmax) of plasma concentration after intramuscular injection of this product is about 3 hours for adults and about 1 hour for children. Intravenous injection of 300mg of this product, the blood concentration of 7mg / L for 10 minutes. The apparent distribution volume (Vd) is about 94L. The protein binding rate of this product is high, ranging from 92% to 94%. This product is widely distributed in the body. It can enter saliva, sputum, respiratory system, pleural effusion, bile, prostate, liver, bladder, appendix, semen, soft tissue, bone and joints, etc., and it can penetrate the placenta, but it is not easy to enter the cerebrospinal fluid. High concentration in bone tissue, bile and urine. This product is metabolized in the liver, and some metabolites can retain antibacterial activity. Metabolites are excreted by bile and urine. About 10% of the dose is excreted from the urine as the active ingredient, and the rest is excreted as inactive metabolites. Blood elimination half-life is about 3 hours, and liver and kidney dysfunction can be slightly prolonged. Hemodialysis and peritoneal dialysis cannot clear this product.

Clindamycin Hydrochloride Storage for Injection

Keep tightly closed in a cool place (not more than 20 ° C).

Clindamycin Hydrochloride for Injection

Controlled antibiotic glass bottles, 5 bottles (0.45g), (0.5g), (0.6g), (0.75g), (0.9g) per box.
Controlled antibiotic glass bottles, 1 bottle (0.6g), (0.9g) per box.