Antibiotic-associated pseudomembranous colitis which may be fatal, develops during or weeks after therapy with clindamycin and is common in women and elderly. This is caused by necrotizing toxins secreted by Clostridium spp., particularly Cl. difficile.
Cl. difficile is an organism which is singled out during administration of oral antimicrobials and grows to a high number in the sigmoid colon. This is treated promptly with oral vancomycin 125-500 mg, 4-6 times per day or with metronidazole.
Allergic rashes and urticaria, Stevens-Johnson-like syndrome, anaphylaxis, transient leucopenia, leucopenia (with agranulocytosis), eosinophilia, thrombocytopenia, erythema multiforme, exfoliative and vesiculobullous dermatitis, polyarthritis, abnormalities of liver function tests, overt jaundice and hepatic damage have been reported with the use of clindamycin.
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