Clindamycin

Key facts

• Clindamycin is an antibiotic (a lincosamide) that stops susceptible bacteria producing the proteins they need to grow; it's taken as capsules, applied as a gel or cream, or given by injection for serious infections.
• It treats skin, dental, bone and joint infections, and certain abdominal and pelvic infections, and it's often chosen when someone is allergic to penicillin.
• Clindamycin carries a notable risk of C. difficile colitis, a serious gut infection that can develop during treatment or even weeks after it finishes; watch for severe or persistent diarrhoea.
• Seek urgent care for watery or bloody diarrhoea with cramping or fever, don't just treat it with an over-the-counter anti-diarrhoea medicine.

What Clindamycin treats

Clindamycin treats skin and soft tissue infections such as cellulitis, dental infections, bone and joint infections, and some abdominal and pelvic infections, and it's used as a topical gel for moderate to severe acne. It's frequently chosen for people with a penicillin allergy.

How Clindamycin works

Clindamycin attaches to the bacterial ribosome, blocking it from assembling the proteins bacteria need to grow and multiply. This slows or stops susceptible bacteria, though it also disrupts the normal balance of bacteria in the gut, which is why it's linked to C. difficile overgrowth.

Before you take it

• Tell your prescriber if you've ever had colitis, inflammatory bowel disease, or diarrhoea linked to a previous antibiotic; clindamycin carries a higher risk of triggering C. difficile infection than many other antibiotics.
• Tell your prescriber about liver disease, and about any neuromuscular condition such as myasthenia gravis, clindamycin can worsen muscle weakness.
• If you're pregnant or breastfeeding, discuss use with your prescriber; oral and injected clindamycin are used only when needed.
• Topical clindamycin for acne shouldn't be combined with other irritating topical treatments without advice, this can increase skin irritation.

Side effects

Nausea, a metallic taste and mild diarrhoea are common.

Stop and seek urgent medical care for any of these:

• Watery or bloody diarrhoea, with or without cramping and fever, at any point during or after treatment.
• Severe rash, blistering or peeling skin.
• Yellowing of the skin or eyes.
• Facial or throat swelling or difficulty breathing.

Safety essentials

• Clindamycin has one of the strongest links to C. difficile colitis of any antibiotic; if diarrhoea becomes severe, watery or bloody, stop the medicine and get medical review promptly, even weeks after finishing the course.
• Don't take anti-diarrhoeal medicines to mask diarrhoea while on clindamycin, they can worsen a developing colitis.
• Finish the prescribed course as directed unless a serious side effect tells you to stop; stopping early risks incomplete treatment and adds to antibiotic resistance.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.