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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For educational use only

Not medical advice. Verify dosing against the BNF and your local trust guidelines before prescribing.