University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

449

Pages:

1
Author:

Shyanne Johnson

2.3 – “Keep “Keeping ing it Clean at the Anae Anaerobic robic Gym”: Clindamycin! • Clindamycin (“Keep it Clean” sign) • Acts on 50S ribosomal subunit inhibiting translocation & protein synthesis. Bacteriostatic. (jammed ribosomal typewriter) • Indications o Has activity against G+ (staph & strep) (Coccoid dumbbells) ▪ Penetrates well into tissues, including skin & soft tissues. First line for group A strep (pie & cellulitis red puffy gloves) ▪ Community acquired MRSA (“No mercy” pharaoh tattoo). On the exam (less so in clinic) linezolid, daptomycin, & are vancomycin first line for MRSA. o Has activity against anaerobic bacteria, including Clostridium & Bacteroides (gasmask) ▪ Actively transported into macrophages so has excellent abscess penetration (e.g. lung abscess) (lung stains with holes in the shirt) ▪ Aspiration PNA (think oral strep spp. & oral anaerobes including Bacteroides fragilis) (lung stains on shirt; bacteria water bottle in background) • With ↓mental status in an elderly person, think aspiration PNA. ▪ Topical clindamycin treats moderate to severe inflammatory acne (mountains) ▪ Endometritis if polymicrobial with anaerobes, which will often Gentamycin + clindamycin (sai for aminoglycoside gentamycin) ▪ Bacterial vaginosis caused by Gardnerella vaginalis (Venus fly traps) ▪ Active for C. diff (exploding toilet) • On exam: Clindamycin above the diaphragm, metronidazole below. Important exceptions in clinical practice: o Clindamycin for C. difficile (exploding toilet) o Clindamycin for Clostridium perfringens (road rash from a stationary bicycle) • Adverse effects o Diarrhea, usually mild & self-limited (mud puddle) o Associated with C-diff pseudomembranous colitis. May occur several weeks after cessation of antibiotic therapy (exploding toilet).