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Clindamycin for Dogs and Cats

By Barbara Forney, VMD

Commonly prescribed for: Wounds, abscesses, and osteomyelitis (Staph aureus)

Species: Dogs and Cats

Therapeutic Class: Broad-spectrum Lincosamide Antibiotic


Basic Information

Clindamycin is a broad-spectrum lincosamide antibiotic. It is efficacious against gram-positive aerobic bacteria (including most Staphylococcus and Streptococci spp), anaerobic bacteria, and some protozoal infections (including Toxoplasma). Clindamycin is approved by the FDA for use in dogs and cats with the following label indications: wounds, abscesses, and osteomyelitis (Staph aureus).


Clindamycin may be either bacteriostatic, or bactericidal depending on drug concentration at the site of infection. It is well distributed and penetrates bone, joints, pleura, peritoneal fluid, the heart, and abscesses. Clindamycin crosses the blood brain barrier and is present in the CNS at about 40% serum levels if there is concurrent meningeal inflammation. Clindamycin is well absorbed orally and is partially metabolized in the liver. It is excreted in urine, feces, and bile.

Dogs and cats

Clindamycin is used to treat a variety of infections in dogs and cats. Its indications in dogs include Staph pyoderma, wounds, abscesses, dental infections, osteomyelitis, susceptible hepatobiliary or respiratory infections, anaerobic infections, intra-abdominal sepsis, actinomycosis, some methicillin resistant Staph infections, and susceptible protozoal infections, including Toxoplasmosis. It is used for very similar indications in the cat.

Clindamycin is considered the treatment of choice for clinical Toxoplasmosis in both dogs and cats. The dose used for the treatment of Toxoplasmosis is generally higher than that for susceptible bacterial infections. Some improvement of clinical signs usually occurs within the first 48 hours of treatment, although neurologic deficits, muscle atrophy, and ocular lesions may take longer to resolve.

When clindamycin is used to treat mixed bacterial infections, it may be combined with aminoglycosides, 3rd generation cephalosporins, or flouroquinolones to provide adequate gram negative coverage.

Food may affect the rate but not the extent of absorption.

Side Effects

  • Gastrointestinal upset including vomiting, diarrhea, and possibly bloody diarrhea. These side effects appear to be due to local GI irritation. Injectable clindamycin does not cause GI distress.
  • Esophagitis, esophageal stricture, and hypersalivation. Clindamycin should be given with food to minimize the possibility of esophageal injury.
  • Localized pain associated with injection.

Precautions

  • Animals with severe kidney or liver dysfunction should be given this drug with caution and may need to receive a lower dose.
  • Clindamycin crosses the placenta and is present in milk. Nursing puppies or kittens may develop diarrhea.
  • Clostridial overgrowth with pseudomembranous colitis has been reported in humans. It has not been reported in dogs and cats.
  • Clindamycin should not be used in horses due to the potential for diarrhea and C. difficil overgrowth. There are isolated reports of its use in very young foals for the treatment of susceptible osteomyelitis.

Drug Interactions

  • Clindamycin may increase the activity of neuromuscular blocking agents, such as pancuronium.
  • Clindamycin may reduce levels of cyclosporine.
  • Clindamycin should not be used in combination with erythromycin due to possible antagonism.

Overdose

  • There is very little information available regarding overdose with clindamycin. It appears that there is a wide margin of safety based on early toxicity studies.

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