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long term use of topical Clindamycin


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#1 prolog

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Posted 28 December 2010 - 06:30 AM

Can Clindamycin solution be used long-term? (like forever)
Does it have internal side effects?


#2 Wynne

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Posted 28 December 2010 - 07:12 AM

No, it should not be used long-term because of the high risk of antibiotic associated colitis (that is intestinal effects) up to and including clostridium difficile. That's a nasty antibiotic resistant bug. ANY antibiotic applied topically WILL have systemic effects and WILL increase antibiotic resistance amongst germs of all sorts.

Solution: use only short term. Get off antibiotics and use a topical retinoid. Antibiotics should never ever be used more than 3-6 months and many should be tapered down to avoid an acne flare/bloom upon discontinuation. Some docs have no problem prescribing antibiotics long-term but within the next few years, that will no longer be standard practice due to the increase in antibiotic resistant bugs. It might be too late by then.

Take responsibility for your health; read the full prescribing information for any medication you take and understand that not all risks or potential side effects will likely ever be fully known.

=Regimen: Cetaphil Sensitive Skin Bar & Avon Anew Advanced Clinical Retexturizing Peel every day & Queen Helene Mint Julep mask weekly=
*Glycolic Acid Product Recommendations *What to do with a cyst/pimple/zit

Wynne 2.9Beta Harder, Better, Faster, Stronger

Please ask questions on the boards, not via PM. That way all benefit. Thanks!


#3 Guest_Timehealsall_*

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Posted 28 December 2010 - 07:19 AM

Sorry to hijack the thread prolog, but i think this might apply to you as well.

Wynne, does this apply to oral antibiotics as well? Ive been on doxy for 5 months (2x a day 100 mg) and i saw my derm today and he suggested to either use it once a day or every other day to see if that keeps me clear.

Do you think i should stop using them since its been 5 months, or gradually decrease to once every other day and then completely get off of them?

#4 Wynne

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Posted 28 December 2010 - 07:20 AM

QUOTE (Timehealsall @ Dec 28 2010, 08:19 AM) <{POST_SNAPBACK}>
Sorry to hijack the thread prolog, but i think this might apply to you as well.

Wynne, does this apply to oral antibiotics as well? Ive been on doxy for 5 months (2x a day 100 mg) and i saw my derm today and he suggested to either use it once a day or every other day to see if that keeps me clear.

Do you think i should stop using them since its been 5 months, or gradually decrease to once every other day and then completely get off of them?

Talk to your doctor again and do in the meantime as your doc suggests....

Take responsibility for your health; read the full prescribing information for any medication you take and understand that not all risks or potential side effects will likely ever be fully known.

=Regimen: Cetaphil Sensitive Skin Bar & Avon Anew Advanced Clinical Retexturizing Peel every day & Queen Helene Mint Julep mask weekly=
*Glycolic Acid Product Recommendations *What to do with a cyst/pimple/zit

Wynne 2.9Beta Harder, Better, Faster, Stronger

Please ask questions on the boards, not via PM. That way all benefit. Thanks!


#5 Guest_Timehealsall_*

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Posted 28 December 2010 - 08:23 AM

hmm, i guess i should do that..

#6 tracy521

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Posted 28 December 2010 - 04:03 PM

hmm i have been using benzaclin for over 2 years now and never thought much about it. so i should try switching to something else? it seems to be the only thing that keeps my severe acne under control. i still get breakouts every so often but its not as frequent as it used to be.
what else is good to use instead?

#7 greentiger87

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Posted 28 December 2010 - 04:28 PM

QUOTE (Wynne @ Dec 28 2010, 07:12 AM) <{POST_SNAPBACK}>
No, it should not be used long-term because of the high risk of antibiotic associated colitis (that is intestinal effects) up to and including clostridium difficile. That's a nasty antibiotic resistant bug. ANY antibiotic applied topically WILL have systemic effects and WILL increase antibiotic resistance amongst germs of all sorts.

Solution: use only short term. Get off antibiotics and use a topical retinoid. Antibiotics should never ever be used more than 3-6 months and many should be tapered down to avoid an acne flare/bloom upon discontinuation. Some docs have no problem prescribing antibiotics long-term but within the next few years, that will no longer be standard practice due to the increase in antibiotic resistant bugs. It might be too late by then.


"It might be too late by then." Isn't this a little alarmist Wynne?

I agree that antibiotics are used far too often, and that alternatives are imperative once clearing occurs, but I also don't think you need to scare people into complying.

IMHO, benzoyl peroxide is the best alternative. It treats acne in the same way, by killing P. acnes, but by a physical mechanism that bacteria can't develop a resistance to. If inflammatory acne is your main problem, large amounts of dilute (2.5%) benzoyl peroxide is your best bet. This is the basic strategy of the Regimen, if you want to check it out.
Morning:
-Cetaphil Daily Facial Cleanser, or Dan's Cleanser
-Paula's Choice 2% Beta Hydroxy Acid Liquid
-CeraVe Moisturizer + Neutrogena Sensitive Skin Sunblock Lotion (zinc oxide and titanium oxide only)

[Night (before bed):
-Cetaphil Daily Facial Cleanser, or Dan's Cleanser
-Dan's BP
-CeraVe Moisturizer

Occasionally:
Dan's AHA
Homemade Niacinamide Toner
Homemade TTO Spot Treatment (Aloe Vera Gel and 20% Tea Tree Oil)

#8 Wynne

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Posted 28 December 2010 - 04:36 PM

QUOTE (greentiger87 @ Dec 28 2010, 05:28 PM) <{POST_SNAPBACK}>
QUOTE (Wynne @ Dec 28 2010, 07:12 AM) <{POST_SNAPBACK}>
No, it should not be used long-term because of the high risk of antibiotic associated colitis (that is intestinal effects) up to and including clostridium difficile. That's a nasty antibiotic resistant bug. ANY antibiotic applied topically WILL have systemic effects and WILL increase antibiotic resistance amongst germs of all sorts.

Solution: use only short term. Get off antibiotics and use a topical retinoid. Antibiotics should never ever be used more than 3-6 months and many should be tapered down to avoid an acne flare/bloom upon discontinuation. Some docs have no problem prescribing antibiotics long-term but within the next few years, that will no longer be standard practice due to the increase in antibiotic resistant bugs. It might be too late by then.


"It might be too late by then." Isn't this a little alarmist Wynne?

MRSA and C-Diff and VRE are on the rise. I fear that with continued indiscriminate use of antibiotics, these antibiotic resistant bacteria will become considerably more common than they already are. When I first started working as a nurse, antibiotic resistant bacteria were actually rather rare, and that was just 14 years ago. Now, there is always at least one person on isolation precautions on any wing (a unit of maybe 15-20 patients). Sometimes there are five! In hospitals, it's worse! My first hospital job had very few patients on iso. Actually, maybe one per every three months. My last....I worked infectious disease so it was everyone. tongue.gif Perhaps my view is skewed because I have worked infection control (for an entire healthcare facility) and infectious disease, but it IS a hugely growing problem and should NOT be minimized.

Take responsibility for your health; read the full prescribing information for any medication you take and understand that not all risks or potential side effects will likely ever be fully known.

=Regimen: Cetaphil Sensitive Skin Bar & Avon Anew Advanced Clinical Retexturizing Peel every day & Queen Helene Mint Julep mask weekly=
*Glycolic Acid Product Recommendations *What to do with a cyst/pimple/zit

Wynne 2.9Beta Harder, Better, Faster, Stronger

Please ask questions on the boards, not via PM. That way all benefit. Thanks!


#9 greentiger87

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Posted 28 December 2010 - 04:53 PM

Yeah, I guess I just worry that when you push it too hard, people's "fanatic" alarm bells go off. Or maybe that's just me, because I'm a professional skeptic biggrin.gif
Morning:
-Cetaphil Daily Facial Cleanser, or Dan's Cleanser
-Paula's Choice 2% Beta Hydroxy Acid Liquid
-CeraVe Moisturizer + Neutrogena Sensitive Skin Sunblock Lotion (zinc oxide and titanium oxide only)

[Night (before bed):
-Cetaphil Daily Facial Cleanser, or Dan's Cleanser
-Dan's BP
-CeraVe Moisturizer

Occasionally:
Dan's AHA
Homemade Niacinamide Toner
Homemade TTO Spot Treatment (Aloe Vera Gel and 20% Tea Tree Oil)

#10 Wynne

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Posted 28 December 2010 - 04:55 PM

^ Makes sense. But *deep voice* BEWARE. lol.gif *clears throat* ok, back to normal, slightly less fanatic.


Honestly, I am a tad fanatic about overuse of antibiotics because of what I've seen. tongue.gif

Take responsibility for your health; read the full prescribing information for any medication you take and understand that not all risks or potential side effects will likely ever be fully known.

=Regimen: Cetaphil Sensitive Skin Bar & Avon Anew Advanced Clinical Retexturizing Peel every day & Queen Helene Mint Julep mask weekly=
*Glycolic Acid Product Recommendations *What to do with a cyst/pimple/zit

Wynne 2.9Beta Harder, Better, Faster, Stronger

Please ask questions on the boards, not via PM. That way all benefit. Thanks!


#11 prolog

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Posted 28 December 2010 - 07:37 PM


QUOTE (Wynne @ Dec 28 2010, 08:12 AM) <{POST_SNAPBACK}>
No, it should not be used long-term because of the high risk of antibiotic associated colitis (that is intestinal effects) up to and including clostridium difficile. That's a nasty antibiotic resistant bug. ANY antibiotic applied topically WILL have systemic effects and WILL increase antibiotic resistance amongst germs of all sorts.

Solution: use only short term. Get off antibiotics and use a topical retinoid. Antibiotics should never ever be used more than 3-6 months and many should be tapered down to avoid an acne flare/bloom upon discontinuation. Some docs have no problem prescribing antibiotics long-term but within the next few years, that will no longer be standard practice due to the increase in antibiotic resistant bugs. It might be too late by then.



Oh that's scary!
My derm didn't tell me that.
I've been using it for quite a while.. A few years..
It is applied on the skin. How does it get down all the way to the intestine?

#12 greentiger87

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Posted 28 December 2010 - 07:41 PM

Small amounts get absorbed by the bloodstream, and then it gets circulated everywhere. And that's what makes it worse, in a way, because the bacteria are exposed to very low concentrations of the antibiotic - giving them ample opportunity to mutate.
Morning:
-Cetaphil Daily Facial Cleanser, or Dan's Cleanser
-Paula's Choice 2% Beta Hydroxy Acid Liquid
-CeraVe Moisturizer + Neutrogena Sensitive Skin Sunblock Lotion (zinc oxide and titanium oxide only)

[Night (before bed):
-Cetaphil Daily Facial Cleanser, or Dan's Cleanser
-Dan's BP
-CeraVe Moisturizer

Occasionally:
Dan's AHA
Homemade Niacinamide Toner
Homemade TTO Spot Treatment (Aloe Vera Gel and 20% Tea Tree Oil)

#13 Guest_Timehealsall_*

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Posted 01 January 2011 - 02:29 AM

QUOTE (greentiger87 @ Dec 28 2010, 04:28 PM) <{POST_SNAPBACK}>
QUOTE (Wynne @ Dec 28 2010, 07:12 AM) <{POST_SNAPBACK}>
No, it should not be used long-term because of the high risk of antibiotic associated colitis (that is intestinal effects) up to and including clostridium difficile. That's a nasty antibiotic resistant bug. ANY antibiotic applied topically WILL have systemic effects and WILL increase antibiotic resistance amongst germs of all sorts.

Solution: use only short term. Get off antibiotics and use a topical retinoid. Antibiotics should never ever be used more than 3-6 months and many should be tapered down to avoid an acne flare/bloom upon discontinuation. Some docs have no problem prescribing antibiotics long-term but within the next few years, that will no longer be standard practice due to the increase in antibiotic resistant bugs. It might be too late by then.


"It might be too late by then." Isn't this a little alarmist Wynne?

I agree that antibiotics are used far too often, and that alternatives are imperative once clearing occurs, but I also don't think you need to scare people into complying.

IMHO, benzoyl peroxide is the best alternative. It treats acne in the same way, by killing P. acnes, but by a physical mechanism that bacteria can't develop a resistance to. If inflammatory acne is your main problem, large amounts of dilute (2.5%) benzoyl peroxide is your best bet. This is the basic strategy of the Regimen, if you want to check it out.


of dilute benzoyl peroxide, what you mean by this.


#14 Sanderella24

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Posted 01 January 2011 - 05:56 AM

Wait. So You're saying acanya gel and benzaclin can't be used long term?