• Clinimycin indications
• Uses of Clinimycin in details
• Clinimycin description
• Clinimycin dosage
• Clinimycin interactions
• Clinimycin side effects
• Clinimycin contraindications

What is Clinimycin?

Clinimycin belongs to the family of medicines called antibiotics.

Topical Clinimycin is used to help control acne. It may be used alone or with one or more other medicines that are used on the skin or taken by mouth for acne.

Topical Clinimycin may also be used for other problems as determined by your doctor.

Clinimycin is available only with your doctor's prescription.

Clinimycin indications

Clinimycin (Clinimycin palmitate HCl) is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria.

Clinimycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of colitis, as described in the WARNING box, before selecting Clinimycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin).

Anaerobes: Serious respiratory tract infections such as empyema, anaerobic pneumonitis and lung abscess; serious skin and soft tissue infections; septicemia; intra-abdominal infections such as peritonitis and intra-abdominal abscess (typically resulting from anaerobic organisms resident in the normal gastrointestinal tract); infections of the female pelvis and genital tract such as endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis and postsurgical vaginal cuff infection.

Streptococci: Serious respiratory tract infections; serious skin and soft tissue infections.

Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.

Pneumococci: Serious respiratory tract infections.

Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to Clinimycin.

In Vitro Susceptibility Testing

A standardized disk testing procedure2 is recommended for determining susceptibility of aerobic bacteria to Clinimycin. A description is contained in the Clinimycin® Susceptibility Disk (Clinimycin) insert. Using this method, the laboratory can designate isolates as resistant, intermediate, or susceptible. Tube or agar dilution methods may be used for both anaerobic and aerobic bacteria. When the directions in the Clinimycin® Susceptibility Powder insert are followed, an MIC (minimal inhibitory concentration) of 1.6 mcg/mL may be considered susceptible; MICs of 1.6 to 4.8 mcg/mL may be considered intermediate and MICs greater than 4.8 mcg/mL may be considered resistant.

Clinimycin Susceptibility Disks 2 mcg. See package insert for use.

Clinimycin Susceptibility Powder 20 mg. See package insert for use.

For anaerobic bacteria the minimal inhibitory concentration (MIC) of Clinimycin can be determined by agar dilution and broth dilution (including microdilution) techniques. If MICs are not determined routinely, the disk broth method is recommended for routine use. THE KIRBY-BAUER DISK DIFFUSION METHOD AND ITS INTERPRETIVE STANDARDS ARE NOT RECOMMENDED FOR ANAEROBES.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Clinimycin and other antibacterial drugs, Clinimycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

How should I use Clinimycin?

Use Clinimycin suppositories as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Clinimycin suppositories comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Clinimycin suppositories refilled.
• Do not use this product if the foil pouch that contains Clindamycin suppositories is torn, open, or not sealed all the way.
• Insert into vagina at bedtime for 3 consecutive days.
• Once inside the vagina, Clinimycin suppositories melts. Lie down as soon as possible to minimize leakage.
• Clinimycin suppositories works best if it is used at the same time each day.
• To clear up your infection completely, use Clinimycin suppositories for the full course of treatment. Keep using it even if you feel better in a few days.
• If you miss a dose of Clinimycin suppositories and you are using it regularly, use it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not use 2 doses at once. If more than one dose is missed, contact your doctor or pharmacist.

Ask your health care provider any questions you may have about how to use Clinimycin suppositories.

Uses of Clinimycin in details

Use: Labeled Indications

Bone and joint infections: Treatment of bone and joint infections, including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections caused by susceptible organisms.

Gynecological infections: Treatment of gynecologic infections, including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes.

Intraabdominal infections: Treatment of intraabdominal infections, including peritonitis and intraabdominal abscess caused by susceptible anaerobic organisms.

Lower respiratory tract infections: Treatment of lower respiratory tract infections, including pneumonia, empyema, and lung abscess caused by susceptible anaerobes, Streptococcus pneumoniae, other streptococci (except Enterococcus faecalis), and S. aureus.

Septicemia: Treatment of septicemia caused by S. aureus, streptococci (except E. faecalis), and susceptible anaerobes.

Skin and soft tissue infection: Treatment of skin and soft tissue infection caused by Streptococcus pyogenes, S. aureus, and susceptible anaerobes.

Off Label Uses

Anthrax

Based on the Centers for Disease Control and Prevention (CDC) expert panel meetings on prevention and treatment of anthrax in adults, Clinimycin is an effective and acceptable alternative for postexposure prophylaxis or treatment of cutaneous anthrax; it is also a first-line option, in combination with other antimicrobials, for the treatment of systemic anthrax. Alternative regimens have also been suggested for other patient populations with anthrax, including injectable drug users who develop injectional anthrax.

Streptococcal (group A) pharyngitis and chronic carriage

Based on the IDSA guidelines for the diagnosis and management of group A streptococcal pharyngitis, Clinimycin is an effective and recommended alternative agent for the treatment of streptococcal pharyngitis and an option for treatment of chronic group A streptococcal carriage.

Surgical prophylaxis

Based on the American Society of Health-System Pharmacists (ASHP) clinical practice guidelines for antimicrobial prophylaxis in surgery, Clinimycin, given as an alternative antibiotic in patients with beta-lactam allergy requiring surgical prophylaxis, is effective and recommended for a number of surgical procedures.

Toxoplasma gondii encephalitis and pneumonitis (treatment/long-term maintenance)

Based on the US Department of Health and Human Services guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents and the American Society of Transplantation Infectious Diseases Community of Practice guidelines on parasitic infections in solid organ transplantation, Clinimycin (with pyrimethamine and leucovorin) is an effective and recommended alternative regimen for the treatment and long-term maintenance therapy of Toxoplasma gondii encephalitis and pneumonitis.

Clinimycin description

Clinimycin is a semisynthetic antibiotic produced by a 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound lincomycin.

Clinimycin phosphate is a water soluble ester of Clinimycin and phosphoric acid.

Clinimycin phosphate is L-threo-α-D-galacto-Octopyranoside, methyl 7-chloro-6, 7, 8-trideoxy-6-[[(1-methyl-4-propyl-2-pyrrolidinyl)carbonyl] amino]-1-thio-, 2-(dihydrogen phosphate), (2S-trans)-.

The molecular formula is C₁₈H₃₄CIN₂O₈PS and the molecular weight is 504.96.

Clinimycin hydrochloride is the hydrated hydrochloride salt of Clinimycin. Clinimycin hydrochloride is Methyl 7-chloro-6, 7, 8-trideoxy-6-(1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L-threo-α-D-galacto-octopyranoside monohydrochloride.

Clinimycin palmitate hydrochloride is a water soluble salt of ester of Clinimycin and palmitic acid. Clinimycin palmitate hydrochloride is Methyl 7-chloro-6, 7, 8-trideoxy-6-(1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L-threo-α-D-galacto-octopyranoside 2-palmitate monohydrochloride.

Clinimycin dosage

Clinimycin Dosage

Generic name: Clinimycin PHOSPHATE 10mg in 1g

Dosage form: aerosol, foam

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Clinimycin Foam is for topical use only, and not for oral, ophthalmic, or intravaginal use.

Apply Clinimycin Foam once daily to affected areas after the skin is washed with mild soap and allowed to fully dry. Use enough to cover the entire affected area.

If there has been no improvement after 6 to 8 weeks or if the condition becomes worse, treatment should be discontinued.

The contents of Clinimycin Foam are flammable; avoid fire, flame and/or smoking during and immediately following application.

More about Clinimycin (Clinimycin topical)

• Side Effects
• During Pregnancy or Breastfeeding
• Dosage Information
• Drug Interactions
• Support Group
• Pricing & Coupons
• 0 Reviews - Add your own review/rating
• Generic Availability

Consumer resources

• Clinimycin
• Clinimycin foam
• Clinimycin

  Topical (Advanced Reading)

• Other brands: Clinimycin T, Clindagel, Clinimycin Vaginal, Clindesse, More (8) »

Professional resources

• Clinimycin (FDA)
• Clinimycin Phosphate topical (AHFS Monograph)

Related treatment guides

• Acne
• Perioral Dermatitis

Clinimycin interactions

See also:
What other drugs will affect Clinimycin?

With simultaneous use of Clinimycin with theophylline, aminophylline, caffeine, there is an increase in their concentration in blood plasma and thus increases the risk of toxic effects.

Erythromycin increases the concentrations of cyclosporine in the blood plasma and may increase the risk of nephrotoxicity.

Drugs that block tubular secretion prolongs T1/2 of erythromycin.

Incompatible with lincomycin, Clinimycin and chloramphenicol (antagonism).

Clinimycin reduces the bactericidal action of beta-lactam antibiotics (penicillins, cephalosporins, carbapenems).

With simultaneous use of erythromycin increases the concentration of theophylline.

At the same time receiving chemotherapy, which is carried metabolism in the liver (carbamazepine, valproic acid, hexobarbital, phenytoin, alfentanil, dizopiramid, lovastatin, bromocriptine), may increase the concentration of these drugs in plasma (an inhibitor of microsomal liver enzymes).

IV injection of erythromycin increases the effects of ethanol (accelerating gastric emptying and decrease the duration of alcohol dehydrogenase in the gastric mucosa).

Erythromycin reduces the clearance of triazolam and midazolam and therefore may increase the pharmacological effects of benzodiazepines.

At the same time taking with terfenadine or astemizole may develop arrhythmias (fibrillation and ventricular flutter, ventricular tachycardia, until death); with dihydroergotamine or non hydrated ergot alkaloids may vasoconstriction to spasm, dysesthesia.

With simultaneous application Clinimycin slows elimination (increases the effect) of methylprednisolone, felodipine and anticoagulants of cumarine series.

In a joint appointment with lovastatin increased rhabdomyolysis.

Erythromycin increases the bioavailability of digoxin.

Erythromycin reduces the effectiveness of hormonal contraceptives.

Clinimycin side effects

See also:
What are the possible side effects of Clinimycin?

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

A total of 439 subjects with mild to moderate acne vulgaris were treated once daily for 12 weeks with Clinimycin Foam.

The incidence of adverse reactions occurring in ≥1% of the subjects in clinical trials comparing Clinimycin Foam and its vehicle is presented in Table 1.

Table 1: Adverse Reactions Occurring in ≥1% of Subjects

Adverse Reactions	Number (%) of Subjects
Clinimycin Foam N = 439	Vehicle Foam N = 154
Headache	12 (3%)	1 (1%)
Application site burning	27 (6%)	14 (9%)
Application site pruritus	5 (1%)	5 (3%)
Application site dryness	4 (1%)	5 (3%)
Application site reaction, not otherwise specified	3 (1%)	4 (3%)

In a contact sensitization study, none of the 203 subjects developed evidence of allergic contact sensitization to Clinimycin Foam.

Postmarketing Experience

The following adverse reactions have been identified during post approval use of Clinimycin Foam: application site pain, application site erythema, diarrhea, urticaria, abdominal pain, hypersensitivity, rash, abdominal discomfort, nausea, seborrhea, application site rash, dizziness, pain of skin, colitis (including pseudomembranous colitis), and hemorrhagic diarrhea. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Abdominal pain and gastrointestinal disturbances, as well as gram-negative folliculitis, have also been reported in association with the use of topical formulations of Clinimycin.

Orally and parenterally administered Clinimycin have been associated with severe colitis, which may end fatally.

Clinimycin contraindications

See also:
What is the most important information I should know about Clinimycin?

You should not use this medication if you are allergic to Clinimycin or lincomycin (Bactramycin, L-Mycin, Lincocin).

Do not take Clinimycin together with erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole, and others).

Before using Clinimycin, tell your doctor if you have kidney disease, liver disease, an intestinal disorder such as colitis or Crohn's disease, or a history of asthma, eczema, or allergic skin reaction.

Take this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Clinimycin will not treat a viral infection such as the common cold or flu.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking Clinimycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

To be sure this medication is not causing harmful effects, your blood may need to be tested often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

If you need surgery, tell the surgeon ahead of time that you are using Clinimycin. You may need to stop using the medicine for a short time.

Active ingredient matches for Clinimycin:

Clindamycin in Bahrain, Ireland.

Oxytetracycline in Ireland.

List of Clinimycin substitutes (brand and generic names)	Sort by popularity
Unit description / dosage (Manufacturer)	Price, USD
Clinika Gel (Indonesia)
Clinika Gel 1 % x 10 g x 1's (Ikapharmindo)	$ 1.92
Clinimycin C
Clinimycin T
Clinimycin-T (Lebanon)
Clinjos (Indonesia)
Clinmas (Indonesia)
Clinmas 150 mg x 30's (Lapi)	$ 9.86
Clinmas 300 mg x 30's (Lapi)	$ 16.74
Clinmax (Hong Kong, India)
Clinmax Skin 15 gm Gel (Palsons Drugs & Chemical Industries)	$ 0.75
CLINMAX 1% W/W GEL 1 tube / 20 GM gel each (Palsons Drugs & Chemical Industries)	$ 1.27
CLINMAX topical gel 1 % w/v x 20g (Palsons Drugs & Chemical Industries)	$ 1.05
Clinmax 1% w/w Gel (Palsons Drugs & Chemical Industries)	$ 1.27
Clinmide (India)
Clinmide Clindamycin 1 % w/w, Nicotinamide 4 % w/w. GEL / 10g (Moraceae Pharmaceuticals (P) Ltd.)	$ 0.84
10g (Moraceae Pharmaceuticals (P) Ltd.)	$ 0.84
Clinmide Skin 10 gm Gel (Moraceae Pharmaceuticals (P) Ltd.)	$ 0.78
CLINMIDE 1%/4% GEL 1 tube / 10 GM gel each (Moraceae Pharmaceuticals (P) Ltd.)	$ 0.90
CLINMIDE topical gel 10g (Moraceae Pharmaceuticals (P) Ltd.)	$ 0.84
Clinmide 1%/4% Gel (Moraceae Pharmaceuticals (P) Ltd.)	$ 0.90
Clinof (India)
Clinof 1% w/w GEL / 20g (Intermed)	$ 0.66
1 % w/w x 20g (Intermed)	$ 0.66
Clinof Skin 20 gm Gel (Intermed)	$ 0.66
CLINOF GEL 1 tube / 20 GM gel each (Intermed)	$ 0.64
CLINOF topical gel 1 % w/w x 20g (Intermed)	$ 0.78
Clinof NA Gel (Intermed)	$ 0.64
Clinott (Thailand)
Clinott -P 150 mg/1 mL x 2 mL (MacroPhar)
Clinott -P 150 mg/1 mL x 4 mL (MacroPhar)
Clinott 150 mg x 10 x 10's (MacroPhar)
Clinott 300 mg x 10 x 10's (MacroPhar)
Clinott cap 150 mg 10 x 10's (MacroPhar)
Clinott cap 300 mg 10 x 10's (MacroPhar)
Clinott-P (Thailand)
Clinott-P inj 150 mg/mL 2 mL x 1's (MacroPhar)
Clinott-P inj 150 mg/mL 4 mL x 1's (MacroPhar)
Clinott-P inj 150 mg/mL 6 mL x 1's (MacroPhar)
Clinox (India)
Clinox 1% w/w T-GEL / 10g (Will Impex)	$ 0.48
CLINOX topical gel 1 % w/w x 10g (Will Impex)	$ 0.48
Clinox-N (India)
Clinox-N Clindamycin 1 % w/w, nicotinamide 4 % w/w. T-GEL / 15g (Will Impex)	$ 0.90
CLINOX-N topical gel 15g (Will Impex)	$ 0.90
Clinred (India)
Clinred 1% T-GEL / 20g (Encore)	$ 1.07
CLINRED GEL 1 tube / 20 GM gel each (Encore)	$ 1.07
CLINRED topical gel 1 % x 20g (Encore)	$ 1.07
Clinred 1% w/w Gel (Encore)	$ 1.17
Clinscar (India)
Clinscar 1% w/w GEL / 10g (Intra Labs India Pvt Ltd)	$ 0.54
1 % w/w x 10g (Intra Labs India Pvt Ltd)	$ 0.54
See 2883 substitutes for Clinimycin

References

1. DailyMed. "OXYTETRACYCLINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. PubChem. "oxytetracycline". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
3. PubChem. "clindamycin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Clinimycin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Clinimycin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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Information checked by Dr. Sachin Kumar, MD Pharmacology