Lincosamide antibiotic
ATC code: J01FF01 (Clindamycin)
Binds the 50S ribosomal subunit and blocks protein synthesis. Active against gram-positive cocci (including community-acquired MRSA), anaerobes. Bioavailability 90%, penetrates bone and abscesses. Reserve for penicillin allergy and suspected MRSA.
Second line
Lactational mastitis with penicillin intolerance or suspected MRSA. Per ABM Protocol #36 2022 and SEGO 2023, second-line 300-450 mg 4 times daily for 10-14 days. Particularly indicated for community-acquired MRSA (CA-MRSA) – usually clindamycin-susceptible, unlike hospital MRSA.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Direct links to regulator labels. Open in a new tab.
Boxed warning
FDA black box: increased risk of severe C. difficile colitis.
Safe in pregnancy.
Compatible. Hale L2. RID about 1.4%, T½ 2.4 h. Possible infant diarrhea – monitor stools. With prolonged courses, infant C. difficile risk also rises – observe.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Clindamycin is evaluated for the following indications with varying evidence strength: Lactational mastitis (evidence tier B). See the full indication matrix with dosing and citations above on this page.
Common side effects of Clindamycin (≥ 1 in 100): Diarrhea (10-30%), Nausea, Metallic taste, Skin rash, Vaginal candidiasis. See the Safety section for uncommon and serious reactions.
FDA category B. Safe in pregnancy.
Compatible. Hale L2. RID about 1.4%, T½ 2.4 h. Possible infant diarrhea – monitor stools. With prolonged courses, infant C. difficile risk also rises – observe.
Clindamycin is contraindicated in: Anaphylaxis to clindamycin or lincomycin; History of inflammatory bowel disease (relative). Full list in the Safety section.
FDA black box: increased risk of severe C. difficile colitis.