Can clindamycin treat a UTI?
Clindamycin does not work against gram-negative bacteria, the most common UTI agents [1]. Therefore, it cannot treat most of the UTI infections.
For example, in one study, clindamycin was used to treat nongonococcal urethritis in men caused by Chlamydia trachomatis, a frequent UTI agent. The results showed that clindamycin could not eradicate the pathogen [2].
Additionally, clindamycin can lead to side effects that affect the kidneys. Thus, the use of clindamycin in severe upper UTI infections can result in profound complications of the therapy [3].
Clindamycin could only treat UTIs caused by gram-positive bacteria, like Staphylococcus aureus [4]. However, the therapy typically starts with a broad-spectrum antibiotic that often includes many gram-positive bacteria. Thus, clindamycin is unlikely to be used to treat a UTI.
Clindamycin is not a standard antibiotic treatment for UTIs. It is because it does not cover most bacteria that can cause UTIs. For instance, it does not cover the most frequent cause of UTIs, E. coli.
What is the standard treatment for UTIs?
The standard or first-line treatment antibiotics for UTI are:
- nitrofurantoin [5],
- Fosfomycin [5],
- first-generation cephalosporins such as cephalexin [6],
- sulfamethoxazole/trimethoprim [6].
Antibiotics like amoxicillin-clavulanate are recommended for cases of kidney infection [5].
It has to be pointed out that out of the first-line treatment for UTI, sulfamethoxazole/trimethoprim has an increasing rate of resistance [5].
What is clindamycin?
Clindamycin is a lincosamide class antibiotic used to treat soft tissue and skin infections [7].
Clindamycin is frequently prescribed by dermatologists as a treatment for acne vulgaris. However, it also treats rosacea, staphylococcal infections, folliculitis, and hidradenitis suppurativa [7].
Clindamycin is characterized by high tissue penetration, excellent oral absorption, and its ability to stimulate the immune system [8].
Owing to its properties, clindamycin is also used in bone and joint infections [9].
What bacterial infections can be treated with clindamycin?
Clindamycin is an antibiotic with a relatively narrow spectrum of activity. It is active against anaerobic bacteria, gram-positive cocci and bacilli, and gram-negative bacilli [10].
For example, clindamycin can treat infections of:
- Staphylococcus aureus [11],
- Streptococcus pyogenes [11],
- Diplococcus pneumoniae [11],
- Prevotella,
- Porphyromonas [12],
- Fusobacterium [12],
- Bacteroides [12].
However, the Bacteroides is becoming resistant to clindamycin, and it may not be the best choice for all infections by this bacterium [13].
How does clindamycin work?
Clindamycin works by inhibiting protein synthesis in bacteria, stopping bacterial multiplication and growth. Once in the bacterial cell, clindamycin binds to the 50S ribosomal subunits and blocks it. It prevents the bacteria from any protein synthesis [14, 15].
Clindamycin also has an anti-inflammatory effect [7] and suppresses the virulence factor production in bacteria like Staphylococcus aureus [16].
Clindamycin also binds one of the reactive oxygen radicals, the hydroxyl radical. It shows that clindamycin can also be an antioxidant, which can contribute to its anti-inflammatory effects [17].
What are the side effects of clindamycin?
The most common side effects of clindamycin include:
- mild allergic reactions,
- itching,
- nausea and vomiting,
- diarrhea,
- abdominal pain,
- joint pain and swelling [18].
Clindamycin can also cause severe side effects. Among them are severe skin reactions, colitis problems with the kidney and liver, and blood cell number changes [18].
Clindamycin topical use can cause dermatological adverse effects. These include itching, redness, burning, dryness, oily skin, and peeling [19].
In rare cases, the use of clindamycin can lead to hepatotoxicity. In this condition, the medication damages the liver [20].
As with many other antibiotics, clindamycin can also lead to pseudomembranous colitis, which can be fatal [21].
Can I take clindamycin without supervision?
Clindamycin should only be taken with a doctor's supervision. It is usually used for particular, serious infections, so a physician's supervision is required [22, 23, 24].
Doctor supervision is needed to monitor the treatment. Regular checkups allow the doctor to identify any possible side effects and prevent possible drug-related conditions.
Additionally, even though the dosage for clindamycin is specified on the label, an infection may require a different amount of the drug. A doctor must calculate the dosage for safety reasons.
One of the most important reasons for a doctor’s supervision of clindamycin therapy are possible drug interactions. Without medical knowledge, it is difficult to identify potentially dangerous interactions.
What medications can interact with clindamycin?
Clindamycin can interact with several medications.
Among the key interactions are:
- rifampicin – it reduces the effectiveness of clindamycin [25],
- rocuronium, tubocurarine, verapamil – clindamycin can potentiate the effect this drugs [26],
- BCG – clindamycin can reduce the action of BCG [27],
- live vaccines for typhoid and cholera – clindamycin can reduce the effectiveness of the vaccines [27].
More than seventy other drug interactions are known. Therefore, it is always essential to consult a doctor before taking clindamycin.
When should I see a doctor for a urinary tract infection?
Seeing a doctor is imperative if you have UTI symptoms. When treating UTIs, time is of the essence. Early detection and intervention stop the infection from spreading and causing serious side effects.
You should make an appointment with a doctor when you experience symptoms like:
- painful and difficult urination,
- reddish, cloudy or foul-smelling urine,
- abdominal or pelvic pain [28].
If you have nausea, vomiting, chills, fever, and back or side pain, you should visit a doctor immediately. These symptoms indicate a kidney infection [28].
Keep in mind that severe consequences can arise from an untreated UTI. Sepsis, renal injury, and kidney scarring may be results from not managed UTI.
Pregnant women should be aware of the symptoms and see a doctor immediately. A UTI can become dangerous to the child [29].
Is clindamycin an over-the-counter medication?
Clindamycin is not an over-the-counter medication. To get clindamycin, a prescription from a licensed doctor is required [30].
Is Clindamycin a generic drug?
Clindamycin is a generic drug and can be bought under many brands. Some examples are Cleocin, Cleocin T, Clinda-Derm, Clindagel, Clindesse, and Xaciato [30].