Macrolide antibiotics are part of treatment options for specific types of vaginal infections. Lincosamide antibiotics are effective in treating certain types of bacteria – anaerobic, streptococcal, staphylococcal, and pneumococcal. The antibiotic is known to have a narrow spectrum of action and is labelled as a bactericide as it works by killing bacteria in addition to preventing its growth. Following subsections offer a detailed view of the medication including any possible clindamycin vaginal cream side effects. This is intended to help users be aware of undesirable outcomes, and identify symptoms on time to prevent or mitigate any adverse effects from use of the antibiotic.

Available formulations and clindamycin mechanism of action

The antibiotic for treating vaginal infections is available in three different forms – topical cream, gel and suppository. It is important to note that clindamycin will not work in the treatment of yeast infections and vaginal fungus infections.

The antibiotic works by preventing bacterial protein synthesis, and this is achieved by binding action.  This disruption of bacterial protein, brings affects cell wall surface, and prevents the ability of bacteria to attach to host cells. Another distinct action of the medication is the “post antibiotic effect”, that affects specific bacterial infections/strains. This occurs due to the ability of the drug to work at the ribosomal level.

Precautions prior to use of clindamycin for vaginal infections

While the antibiotic is known to be relatively safe for most users and has been approved for use by the FDA, it is necessary to exercise caution prior to its use. Users are to bear in mind the possibilities of undesirable effects, and individuals belonging to certain categories are to rule out any risk of exposure to specific effects. For instance, individuals with a history of allergies are likely to be exposed to clindamycin allergic reactions. This includes individuals with allergies to food products, preservatives and dyes, in addition to animal dander. Allergic reactions to medicines need to be carefully monitored, as this has the possibility of turning into an adverse or severe reaction.

While studies have been carried out on users during trials, adequate studies have not been performed on children below the age of twelve years. It is therefore necessary to use with extra caution in the event the topical application is prescribed from children of this age group. Elderly patients are not known to be at risk of possible untoward effects of the medication, as studies have not indicated any negative outcomes. Similar to pediatric uses, studies have not been performed on breastfeeding women to determine the safety and efficacy of the antibiotic. It is therefore extremely important for breastfeeding women to seek explicit advice regarding its use. Ideally, the best option would be to weigh what is important and decide accordingly.

Individuals at high risk of undesirable effects

Certain conditions are known to have an impact on the efficacy of the medication, or the medication may aggravate the conditions. It is therefore considered unsuitable for use by patients diagnosed with specific conditions. Patients with a history or suffering from colitis symptoms, stomach disease or bowel conditions are advised to avoid the antibiotic till the condition is resolved. In the event that it is absolutely necessary to use the antibiotic, extreme caution is advised. It is also necessary to use the drug only with explicit advice of the doctor, after intimation of the condition.

Ideal dosage as per diagnosed conditions

When recommended for bacterial vaginosis, the ideal dosage of the cream formulation is 100 mg for patients above the age of 13, for a period that could be between three to seven days depending on the condition. Pregnant women are to use the same dose of the cream formulation for a period of seven days.  When the gel formulation is used, the dosage is five gms; it is important bear in mind that the gel is typically used as a one-day treatment and not a course. Specialists recommend suitable treatment options, depending on the condition and the desired outcomes.

Possible clindamycin vaginal cream side effects

All medications come with the possibility of undesirable effects and clindamycin is no exception. Effects may be broadly classified into two different types – mild and severe. The mild or moderate effects are known to be more frequently occurring in nature, and may not always require mediation or intervention to treat the effects. The serious or adverse effects are typically rare in occurrence and affect only a relatively small portion of users. These effects have the potential to turn in to serious outcomes, and in most cases require medical attention. It is necessary identify the symptoms and take necessary remedial or preventive action wherever required.

It is important to add that all users of the topical antibiotic are unlikely to experience effects – a small section of users are known to be fully free from all effects. The actual effects depend on a variety of factors – such as the age of the individual, the strength of the application, the period of use, the intensity of the condition, other medications in use and presence of other medical conditions. Here is a compilation of some of the commonly occurring and frequently reported effects of clindamycin 2% vaginal cream for infections. This is intended to only serve as a reference and is not claimed to be a complete or exhaustive listing of effects.

Itching sensations in the vagina and the genital area are commonly reported, while some are known to experience pain during intercourse. Discharge from the vagina as a possible side effect is also relatively common.  Other effects that may be experienced include diarrhea, dizzy feelings, and possible headache. Feelings of nausea and vomiting are also likely to be experienced by a small section of users. Certain conditions may also be experienced, though the incidence rates are rare. This includes burning sensation, outbreak of rashes, and reddish appearance. In addition to this, there is also the possibility of swelling or indications of skin conditions.

Interactions of clindamycin with other drugs

In addition to clindamycin vaginal cream side effects there is also the possibility of interactions with other drugs. This occurs when two or more medications are used at the same time, either for the same condition or for different conditions. This is attributed to the conflict in mechanisms of action of the two medications and may trigger one of three different outcomes. For instance, either of the two medications may end up with increased potency, decrease in potency or could end up with aggravated side effects. In other words, the possible undesirable outcomes of either or both the medications may end up with greater intensity when taken as a combination.

Remedial measures to mitigate this include temporary discontinuation of either drug or medication, or replacement with an alternative drug. This is decided on the basis of importance of each medication, and the drug with relatively lesser importance or criticality is discontinued or suspended. In certain circumstances, it may be necessary to take both medications, and in such instances, the only option is to stagger the intake schedule and alter the dosage or strength. Here is a short compilation of drugs or medications that may interact with clindamycin. This is not claimed to be complete or exhaustive, and only serves as a broad reference.

Drugs that are commonly known to interact with the antibiotic include cholera vaccines, and certain other antibiotics for treating bacterial infections, such as erythromycin. Other medications that may interact with clindamycin include certain muscle relaxants and neuromuscular blocking agents.  Interactions are not limited to drugs alone and may also extend to OTC formulations, health supplements, food products, alternative medicines, and natural therapies

Avoid effects with simple precaution

Simple precautions help to avoid undesirable outcomes. For instance, women and children recommended a weeklong schedule are not to take double dose to make up for missed doses. The best method is to skip the dose and take the next dose at the scheduled time.  Other precautions that will help mitigate or prevent adverse outcomes include the following. The antibiotic is known to trigger diarrhea, and this could occur even a few months after the treatment has concluded. It is therefore necessary to seek medical attention before taking OTC medications for diarrhea.

One of the effects of the antibiotic is possible dizzy feelings. Women are therefore advised not to drive or operate machinery that require a high state of alertness. Another possible effect is the impact on polyurethane condoms, and this could last for as much as one week after the treatment has concluded. It is therefore safe to use latex or polyisoprene condoms to ensure protection from sexually transmitted diseases, and to prevent unplanned pregnancies. The medication is also known to cause vaginal yeast infection, and women are to ascertain the symptoms and seek suitable treatment. Medically known as candidiasis, the condition causes vaginal itching, white discharge and possible pain when indulging in sex. Identify the symptoms and take suitable remedial action.

Need for extra hygiene

By virtue of the nature of applications in the vagina, it is necessary to practice additional or increased hygiene. Leakage of the applied antibiotic from the vagina may cause stains and discoloration of clothing. Use of suitable barriers such as sanitary napkins, are recommended to prevent stains, and to ensure adequate hygiene. The use of tampons during treatment is to be avoided fully, as the tampons may absorb the medication, rendering it in effective. The use of cotton panties is recommended, in place of panties made with nylon or rayon. During the period of treatment, sex is to be avoided, and the use of vaginal insertions are to be strictly avoided – for instance douches.


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