Clindamycin

Topical Antibiotic

Pregnancy

No adverse effects of topical clindamycin were observed in animal studies to date. Clindamycin crosses the placenta when clindamycin is taken orally. When applied topically, only a small fraction of clindamycin enters the bloodstream.

If an antibiotic is needed during pregnancy, topical clindamycin may be considered, however the amount of clindamycin that enters the bloodstream is dependent on how long it is used and how large an area of skin to which it is applied. Therefore, it is important to consult your physician regarding the use of topical clindamycin during pregnancy.  

Category: B

Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).

Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category D

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Breastfeeding

Excretion into human milk: Yes (after oral or intravenous dosing); unknown after topical use. 

Clindamycin may cause adverse effects related to the infant’s intestines when used orally while breastfeeding, such as diarrhea, diaper rash, thrush, or rarely bloody stool. These adverse effects are however unlikely when topical clindamycin is used. The risk of diarrhea may be increased when clindamycin is applied to the nipple area. Do not apply clindamycin to the nipple area and make sure the infant’s skin does not come into contact with the areas of skin that have been treated with clindamycin. Also, only apply water-based cream, gel or liquids to the breast to avoid possible exposure to mineral paraffins via licking. 

If an antibiotic is needed during breastfeeding, topical clindamycin may be considered, however, the amount of clindamycin that enters the bloodstream is dependent on how long it is used and how large an area of skin to which it is applied. Therefore, it is important to consult your physician regarding the use of topical clindamycin during breastfeeding.  

If you are breastfeeding, speak with your physician before you use clindamycin. Weigh the benefits against potential risks before using clindamycin while breastfeeding. 

References
  1. Medlineplus.gov. (2018). Clindamycin Topical: MedlinePlus Drug Information. [online] Available at: https://medlineplus.gov/druginfo/meds/a609005.html [Accessed 16 Apr. 2018].
  2. Ncbi.nlm.nih.gov. (2018). Clindamycin (topical route). [online] Available at:https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0044546/ . [Accessed 16 Apr. 2018].
  3. Toxnet.nlm.nih.gov. (2018). Clindamcyin. [online] Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~KXyUEZ:1. [Accessed 16 Apr. 2018].
  4. Uptodate.com. (2018). Clindamycin (topical). [online] Available at: https://www.uptodate.com/contents/clindamycin-topical-patient-drug-information?search=clindamycin%20topical&source=search_result&selectedTitle=5~34&usage_type=default&display_rank=5. [Accessed 16 Apr. 2018].
  5. Epocrates.com. (2018). Clindamycin. [online] Available at: https://online.epocrates.com/drugs/51010/clindamycin-topical/Monograph. [Accessed 16 Apr. 2018].