AlternativeDalacin
Clindamycin
Lincosamide antibiotic
GBS prophylaxis when severe penicillin allergy; BV alternative.
OralIVVaginal cream
First-line for
- GBS prophylaxis (severe pen allergy, susceptible)
- Bacterial vaginosis (alternative to metronidazole)
Mechanism
Binds 50S ribosomal subunit → ↓ protein synthesis (bacteriostatic).
Clinda watch
- C — C. difficile risk
- L — Liver caution
- I — IV 900 mg q8h GBS
Dosing
- GBS prophylaxis
- 900 mg IV q8h until delivery (only if isolate clinda-sensitive)
- BV
- 2% cream PV nightly ×7 days
Contraindications
- CautionPast pseudomembranous colitis
Side effects
- C. difficile colitis (highest-risk antibiotic)
- Rash, ↑ LFTs
Fetal & maternal notes
- • Compatible with pregnancy & breastfeeding.
Key interactions
NMJ blockers
Caution↑ neuromuscular blockade
Clinical pearls
- 💡 If clinda-resistant GBS + severe pen allergy → vancomycin.
- 💡 Stop promptly if diarrhoea — test for CDT.
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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