The Basics

What is Clindamycin?

Antibiotic used for the treatment bacterial infections, like bone or joint infections, pelvic inflammatory disease, strep throat, pneumonia, middle ear infections, and endocarditis. It can also be used to treat acne, and some cases of methicillin-resistant Staphylococcus aureus.

Brand names for Clindamycin

Cleocin

How Clindamycin is classified

Anti-Infective Agents, Antibacterial Agents

Clindamycin During Pregnancy

Clindamycin pregnancy category

Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Clindamycin while pregnant

In clinical trials with pregnant women, the systemic administration of clindamycin during the second and third trimesters, has not been associated with an increased frequency of congenital abnormalities. Clindamycin should be used during the first trimester of pregnancy only if clearly needed. There are no adequate and well-controlled studies in pregnant women during the first trimester of pregnancy. Because animal reproduction studies are not always predictive of the human response, this drug should be used during pregnancy only if clearly needed. Reproduction studies performed in rats and mice using oral doses of clindamycin up to 600 mg/kg/day (3.2 and 1.6 times the highest recommended adult human dose based on mg/m², respectively) or subcutaneous doses of clindamycin up to 250 mg/kg/day (1.3 and 0.7 times the highest recommended adult human dose based on mg/m², respectively) revealed no evidence of teratogenicity.

Taking Clindamycin While Breastfeeding

What are recommendations for lactation if you're taking Clindamycin?

Clindamycin has the potential to cause adverse effects on the breastfed infant’s gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. Vaginal application is unlikely to cause infant side effects, although about 30% of a vaginal dose is absorbed. Infant side effects are unlikely with topical administration for acne; however, topical application to the breast may increase the risk of diarrhea if it is ingested by the infant. Only water-miscible cream, foam, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[1]

Maternal / infant drug levels

Clindamycin has the potential to cause adverse effects on the breastfed infant’s gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. Vaginal application is unlikely to cause infant side effects, although about 30% of a vaginal dose is absorbed. Infant side effects are unlikely with topical administration for acne; however, topical application to the breast may increase the risk of diarrhea if it is ingested by the infant. Only water-miscible cream, foam, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[1]

Possible effects of Clindamycin on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Clindamycin

(Systemic infections) Amoxicillin and Clavulanic Acid, Doxycycline, Erythromycin; (Methicillin-resistant Staph. aureus) Doxycycline, Minocycline, Trimethoprim-Sulfamethoxazole, Vancomycin; (Bacterial Vaginosis) Metronidazole; (Topical for Acne) Azelaic Acid, Benzoyl Peroxide, Erythromycin, Tretinoin; (Topical for Skin infections) Bacitracin, Mupirocin.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Noti A, Grob K, Biedermann M et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003;38:317-25. PMID: 14623482
2. Matsuda S, Mori S, Azuma S. Clinical evaluation of clindamycin in gyneco-obstetrics. Chemotherapy (Tokyo). 1969;17:899-900.
3. Smith JA, Morgan JR, Rachlis AR et al. Clindamycin in human breast milk. Can Med Assoc J. 1975;112:806. Letter. PMID: 20312646
4. Steen B, Rane A. Clindamycin passage into human milk. Br J Clin Pharmacol. 1982;13:661-4. PMID: 7082533
5. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol. 1984;5:57-60. PMID: 6743732
6. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997;32:288-92. PMID: 9596854
7. Mann CF. Clindamycin and breast-feeding. Pediatrics. 1980;66:1030-1. Letter. PMID: 7454470

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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