M.V.S. Lilith Kumar*, k. Siva, Y. Sarath, Y.N.S.Sujitha, M.Lavanya
Narayana Pharmacy College, chintareddypalem, Nellore, Andhrapradesh, India.
Topical clindamycin has been accepted as being effective, safe and well tolerated in the treatment of acne. It is mainly used to treat the “acne vulgaris“. The more severe form of acne is characterized by the presence of painless nodules this drug belongs to the class of antibiotics known as lincosamides. Combinations containing clindamycin and benzoyl peroxide have been shown to be effective on skin Clindamycin inhibits bacteria protein synthesis at the ribosomal level by binding to the 50S ribosomal subunit and affecting the process of peptide chain initiation. Although acne is not a serious health threat, severe acne can lead to disfiguring, permanent scarring Clindamycin is used primarily to treat anaerobic infections caused by susceptible anaerobic bacteria, skin, and peritonitis
Key words: Clindamycin, lincosamides, benzoyl peroxide, acen vulgaris
Clindamycin phosphate topical gel, 1% is a topical antibiotic approved for the treatment of acne vulgaris. The term “acne vulgaris” refers to the more common form of acne, consisting of non-inflammatory and mildly inflammatory lesions. By inhibiting bacteria protein synthesis at the ribosomal level (the site of protein synthesis) clindamycin is believed to kill bacteria associated with acne. Nearly million people were affected with acne, making it the most common skin disease. Severe acne can lead to disfiguring, permanent scarring, which can be upsetting for people who suffer from the disorder. Clinically clindamycin phosphate gel was more effective than a vehicle gel in the treatment of mild to moderate acne vulgaris. The 12-week, multicenter, randomized, vehicle-controlled trial compared clindamycin phosphate topical gel, 1% once daily to a vehicle gel administered once daily. The mean percent reduction in lesion counts at the end of treatment was 51% for clindamycin phosphate gel versus 40% for the vehicle gel for inflammatory lesions. For non-inflammatory lesions, the mean percent reduction was 25% for clindamycin phosphate gel and 12% for the vehicle gel. There was no signal for contact sensitization in the clinical trials under normal use conditions.
Mechanism of Action
Clindamycin has a bacteriostatic effect. The main mechanism involved in this is, Clindamycin inhibits bacteria protein synthesis at the ribosomal level by binding to the 50S ribosomal subunit and affecting the process of peptide chain initiation. The structures of the complexes between several antibiotics (including clindamycin) and a deinococcus radiodurans ribosome have been solved by X-ray crystallography. The combinations containing with, clindamycin and benzoic peroxide have been shown to be effective but the irritation caused by the concentration of benzoyl peroxide in the more commonly used, fixed combinations can be limiting. Clindamycin Phosphate and Benzoyl Peroxide Gel, 1.2%/5% contains clindamycin phosphate, (7(S)-chloro-7-deoxylincomycin-2-phosphate), equivalent to 1% clindamycin, and 5% benzyl peroxide.
Adverse reactions associated with the use of clindamycin phosphate gel include itching and peeling skin. Colitis has been reported as adverse reactions in subjects treated with oral and parenteral (intravenous) formulations of clindamycin, and have been reported rarely with topical clindamycin. Abdominal pain and gastrointestinal disturbances, as well as gram-negative folliculate (bacterial infection and inflammation of hair follicles), have also been reported in association with the use of topical formulations of clindamycin
Clindamycin and erythromycin containing products should not be used in combination. In vitro studies have shown antagonism between these two antimicrobials. Safety and effectiveness of this product in pediatric patients below the age of 12 have not been established. The colitis is usually characterized by sever persistent diarrhea and sever abdominal cramps and may be associated with the passage of blood and mucus so Dermatologists, general practitioners, have overlooked. Orally and parentally administrated clindamycin has been associated with sever colitis which may result in patient deaths.
1. Datum RS (2007).”Clinical practice. Skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aurous 357 (4): 380–90.
2. Looking bill DP, Chalkier DK, Lindholm JS, et al. (1997). “Treatment of acne with a combination clindamycin/benzyl peroxide gel compared with clindamycin gel, benzyl peroxide gel and vehicle gel: combined results of two double-blind investigations”. J Am Acad Dermatol 37 (4): 590–5.