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Clindamycin Side Effects

Medically reviewed by Drugs.com. Last updated on Aug 15, 2023.

Applies to clindamycin: oral capsule, oral powder for solution. Other dosage forms:

Warning

Oral route (Powder for Solution)

Pseudomembranous colitis has been reported with nearly all antibacterial agents, including clindamycin, and may range in severity from mild to life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents. Because clindamycin therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate. Diarrhea, colitis, and pseudomembranous colitis have been observed to begin up to several weeks following cessation of therapy with clindamycin.

Oral route (Capsule)

Clostridium difficile associated diarrhea (CDAD) has been reported with nearly all antibacterial agents, including clindamycin, and may range in severity from mild diarrhea to life-threatening colitis and has been observed to begin over 2 months after the administration of antibacterial agents. It is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents. If CDAD is confirmed or suspected, antibiotic therapy not directed against Clostridium difficile may need to be discontinued. Because clindamycin therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate.

Serious side effects of Clindamycin

Along with its needed effects, clindamycin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking clindamycin:

Rare

Incidence not known

For Healthcare Professionals

Applies to clindamycin: compounding powder, injectable solution, intravenous solution, oral capsule, oral powder for reconstitution.

Gastrointestinal

Common (1% to 10%): Pseudomembranous colitis, diarrhea, abdominal pain

Uncommon (0.1% to 1%): Dysgeusia, nausea, vomiting

Frequency not reported: Esophageal ulcers, esophagitis (oral preparations)[Ref]

The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment and is associated with the presence of Clostridium difficile toxin in the stool. Pseudomembranous colitis may also be associated with toxic megacolon, which can be life-threatening.

An unpleasant or metallic taste has occasionally been reported after high doses of IV clindamycin.[Ref]

Dermatologic

Common (1% to 10%): Maculopapular rash

Uncommon (0.1% to 1%): Urticaria

Rare (less than 0.1%): Erythema multiforme, pruritus

Frequency not reported: Toxic epidermal necrolysis, Stevens-Johnson syndrome, exfoliative dermatitis, bullous dermatitis, generalized mild to moderate morbilliform-like rash, acute generalized exanthematous pustulosis (AGEP), Sweet's Syndrome

Postmarketing reports: Serious cutaneous adverse reaction[Ref]

Rash was particularly common in AIDS patients.

A 47-year-old female patient with multiple comorbidities was diagnosed with Sweet's Syndrome. The patient's symptoms developed 2 days after initiating oral clindamycin therapy for a tooth infection. The patient's symptoms persisted despite tooth extraction and continuance of antibiotic treatment with intravenous, then oral, clindamycin. Following discontinuation of clindamycin, the patient's symptoms resolved over several days. Drug-induced Sweet's syndrome was determined based on the temporal relationship of the patient's symptoms, the beginning and end of clindamycin therapy, and the exclusion of other etiologies.

Three days after starting oral clindamycin for the persistence of symptoms following a root canal, a 34-year-old male patient reported "pimples" on his scalp which changed to pustules 24 hours later. The lesions progressed and the patient's antibiotic therapy was discontinued. Two days later, the rash improved considerably. The patient met the diagnostic criteria for drug-induced Sweet's syndrome and clindamycin was the most likely cause due to the timeline of antibiotic therapy and the patient's improvement following its discontinuation.[Ref]

Hypersensitivity

Frequency not reported: Anaphylactoid reactions, drug reaction with eosinophilia and systemic systems (DRESS)[Ref]

Cardiovascular

Common (1% to 10%): Thrombophlebitis (after IV infusion)

Uncommon (0.1% to 1%): Cardiorespiratory arrest, hypotension[Ref]

Cardiorespiratory arrest and hypotension have been reported after too rapid IV administration. Thrombophlebitis has been reported after intravenous infusion.[Ref]

Genitourinary

Frequency not reported: Vaginitis[Ref]

Hematologic

Uncommon (0.1% to 1%): Eosinophilia

Frequency not reported: Neutropenia, leucopenia, agranulocytosis, thrombocytopenia[Ref]

Neutropenia (ANC 945 cells/mm3) occurred in a 68-year-old male 6 days after receiving a single 600 mg oral dose of clindamycin. The neutrophil count normalized after 2 weeks.[Ref]

Hepatic

Common (1% to 10%): Liver function test abnormalities

Frequency not reported: Jaundice[Ref]

Local

Frequency not reported: Injection site irritation, pain, abscess formation[Ref]

Pain, induration, and sterile abscess have been reported after intramuscular administration.[Ref]

Musculoskeletal

Frequency not reported: Polyarthritis[Ref]

Renal

Frequency not reported: Renal dysfunction, as shown by azotemia, oliguria, and/or proteinuria[Ref]

Frequently asked questions

References

1. Leigh DA, Simmons K, Williams S. Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study. J Antimicrob Chemother. 1980;6:639-45.

2. Wilson DH. Clindamycin in the treatment of soft tissue infections: a review of 15,019 patients. Br J Surg. 1980;67:93-6.

3. Mason SJ, O'Meara TF. Drug-induced esophagitis. J Clin Gastroenterol. 1981;3:115-20.

4. Davies J, Beck E. Recurrent colitis following antibiotic-associated pseudomembranous colitis. Postgrad Med J. 1981;57:599-601.

5. Milstone EB, McDonald AJ, Scholhamer CF Jr. Pseudomembranous colitis after topical application of clindamycin. Arch Dermatol. 1981;117:154-5.

6. Cone JB, Wetzel W. Toxic megacolon secondary to pseudomembranous colitis. Dis Colon Rectum. 1982;25:478-82.

7. Parry MF, Rha CK. Pseudomembranous colitis caused by topical clindamycin phosphate. Arch Dermatol. 1986;122:583-4.

8. Van Ness MM, Cattau EL Jr. Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment. Am J Gastroenterol. 1987;82:374-7.

9. Product Information. Cleocin (clindamycin). Pharmacia and Upjohn. 2002;PROD.

10. Meadowcroft AM, Diaz PR, Latham GS. Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream. Ann Pharmacother. 1998;32:309-11.

11. Cerner Multum, Inc. UK Summary of Product Characteristics.

12. George WL, Sutter VL, Finegold SM. Antimicrobial agent-induced diarrhea--a bacterial disease. J Infect Dis. 1977;136:822-8.

13. Geddes AM, Bridgwater FA, Williams DN, Oon J, Grimshaw GJ. Clinical and bacteriological studies with clindamycin. Br Med J. 1970;2:703-4.

14. Bartlett JG. Narrative review: the new epidemic of Clostridium difficile-associated enteric disease. Ann Intern Med. 2006;145:758-64.

15. de Groot MC, van Puijenbroek EP. Clindamycin and taste disorders. Br J Clin Pharmacol. 2007;64:542-5.

16. Cerner Multum, Inc. Australian Product Information.

17. Vidal C, Iglesias A, Saez A, Rodriguez M. Hypersensitivity to clindamycin. DICP. 1991;25:317.

18. Clark BM, Homeyer DC, Glass KR, D'Avignon LC. Clindamycin-Induced Sweet's Syndrome. Pharmacotherapy. 2007;27:1343-6.

19. Paquet P, Schaaflafontaine N, Pierard GE. Toxic epidermal necrolysis following clindamycin treatment. Br J Dermatol. 1995;132:665-6.

20. Lammintausta K, Tokola R, Kalimo K. Cutaneous adverse reactions to clindamycin: results of skin tests and oral exposure. Br J Dermatol. 2002;146:643-8.

21. Kapoor R, Flynn C, Heald PW, Kapoor JR. Acute generalized exanthematous pustulosis induced by clindamycin. Arch Dermatol. 2006;142:1080-1.

22. Tian D, Mohan RJ, Stallings G. Drug rash with eosinophilia and systemic symptoms syndrome associated with clindamycin. Am J Med. 2010;123:e7-8.

23. Miller Quidley A, Bookstaver PB, Gainey AB, Gainey MD. Fatal clindamycin-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. Pharmacotherapy. 2012.

24. Bubalo JS, Blasdel CS, Bearden DT. Neutropenia after single-dose clindamycin for dental prophylaxis. Pharmacotherapy. 2003;23:101-3.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.