It is necessary to avoid long-term use, as this increases the incidence of side effects and the resistance of bacteria to clindamycin may develop.
Clindamycin, used externally, is absorbed into the body only to a small extent. In patients who have a history of colitis caused by the use of antibiotics, ulcerative and inflammatory bowel disease, Crohn's disease, it is necessary to consider the risk of developing possible undesirable side effects from the digestive system before beginning therapy.
The use of clindamycin (as well as other antibiotics) orally or parenterally in a number of cases is associated with the development of pseudomembranous colitis. Pseudomembranous colitis can appear both on the background of long-term use, and 2-3 weeks after cessation of treatment; is manifested by diarrhea, leukocytosis, fever, abdominal pain (sometimes accompanied by discharge with mucous masses of blood and mucus).If these phenomena occur in mild cases, it is sufficient to cancel the treatment and apply ion-exchange resins (colestramine, colestipol), in severe cases, compensation for loss of fluid, electrolytes and protein, the appointment of vancomycin inwards or metronidazole is indicated. Do not use drugs that inhibit the intestinal motility.
Clindamycin may exhibit cross-resistance to lincomycin and erythromycin.
Avoid contact with the eyes and mucous membranes of the nose and mouth, as well as the wound skin surface.
In case of accidental contact with the eyes or mucous membranes, rinse them with plenty of cold water.
After prolonged use clindamycin may be present in serum and urine in small concentrations.
Long-term treatment with clindamycin in elevated doses can lead to an increase in insensitive flora.