Clindamycin is an antibiotic used for the treatment of a number of bacterial infections, including bone or joint infections, pelvic inflammatory disease, strep throat, middle ear infections, endocarditis. It can be used to treat acne, some cases of methicillin-resistant Staphylococcus aureus. In combination with quinine, it can be used for malaria, it is available by mouth, by injection into a vein, as a cream to be applied to the skin or in the vagina. Common side effects include nausea, diarrhea and pain at the site of injection, it increases the risk of hospital-acquired Clostridium difficile colitis about fourfold and thus is only recommended when other antibiotics are not appropriate. Alternative antibiotics may be recommended as a result, it appears to be safe in pregnancy. It is of the lincosamide class and works by blocking bacteria from making protein. Clindamycin was first made in 1966 from lincomycin, it is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.
It is available as a generic medication and is not expensive. The wholesale cost in the developing world is about US$0.06–0.12 per pill. In the United States, it costs about $2.70 per dose. In 2016, it was the 151st most prescribed medication in the United States, with more than four million prescriptions. Clindamycin is used to treat anaerobic infections caused by susceptible anaerobic bacteria, including dental infections, infections of the respiratory tract and soft tissue, peritonitis. In people with hypersensitivity to penicillins, clindamycin may be used to treat infections caused by susceptible aerobic bacteria, as well, it is used to treat bone and joint infections those caused by Staphylococcus aureus. Topical application of clindamycin phosphate can be used to treat mild to moderate acne. For treatment of acne, in the long term the combined use of topical clindamycin and benzoyl peroxide was similar to salicylic acid plus benzoyl peroxide. Topical clindamycin plus topical benzoyl peroxide is more effective than topical clindamycin alone.
It is most effective against infections involving the following types of organisms: Aerobic Gram-positive cocci, including some members of the Staphylococcus and Streptococcus genera, but not enterococci. Anaerobic, Gram-negative rod-shaped bacteria, including some Bacteroides and Prevotella, although resistance is increasing in Bacteroides fragilis. Most aerobic Gram-negative bacteria are resistant to clindamycin, as are the facultative anaerobic Enterobacteriaceae. A notable exception is Capnocytophaga canimorsus, for which clindamycin is a first-line drug of choice; the following represents MIC susceptibility data for a few medically significant pathogens. Staphylococcus aureus: 0.016 μg/ml - >256 μg/ml Streptococcus pneumoniae: 0.002 μg/ml - >256 μg/ml Streptococcus pyogenes: <0.015 μg/ml - >64 μg/ml When testing a gram-positive culture for sensitivity to clindamycin, it is common to perform a "D-test" to determine if there is a macrolide-resistant subpopulation of bacteria present. This test is necessary because some bacteria express a phenotype known as MLSB, in which susceptibility tests will indicate the bacteria are susceptible to clindamycin, but in vitro the pathogen displays inducible resistance.
To perform a D-test, an agar plate is inoculated with the bacteria in question and two drug-impregnated disks are placed 15–20 mm apart on the plate. If the area of inhibition around the clindamycin disk is "D" shaped, the test result is positive and clindamycin should not be used due to the possibility of resistant pathogens and therapy failure. If the area of inhibition around the clindamycin disk is circular, the test result is negative and clindamycin can be used. Given with chloroquine or quinine, clindamycin is effective and well tolerated in treating Plasmodium falciparum malaria. Clindamycin should not be used as an antimalarial by itself, although it appears to be effective as such, because of its slow action. Patient-derived isolates of Plasmodium falciparum from the Peruvian Amazon have been reported to be resistant to clindamycin as evidenced by in vitro drug susceptibility testing. Clindamycin may be useful in skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus.
Many strains of MRSA are still susceptible to clindamycin. While it has been used in intraabdominal infections, such use is not recommended due to resistance. Clindamycin is used in cases of suspected toxic shock syndrome in combination with a bactericidal agent such as vancomycin; the rationale for this approach is a presumed synergy between vancomycin, which causes the death of the bacteria by breakdown of the cell wall, clindamycin, a powerful inhibitor of toxin synthesis. Both in vitro and in vivo studies have shown clindamycin reduces the production of exotoxins by staphylococci. Clindamycin has been proven to decrease the risk of premature births in women diagnosed with bacterial vaginosis during early pregnancy to about a third of the risk of untreated women; the combination of clindamycin and quinine is the standard treatment for severe babesiosis. Clindamycin may als
Edwin Asa Dix, the pen name of Edwin Augustus Dix, was an American author. Dix was born in New Jersey, to John Edwin and Mary Joy Dix, he attended the Newark Latin School Princeton University from which he graduated in 1881 as Latin Salutatorian, first in his class with highest grade point average awarded to that date. While at Princeton he was managing editor of The Lit and was awarded the Boudinot Historical Fellowship and other prizes. In 1884 he graduated from Columbia Law School with highest honors, subsequently admitted to the bar in New York and New Jersey. Dix toured the world from 1890-92. On August 15, 1895, he married Marion Alden Olcott at New York, they had no children, spent much of their married life abroad, wintering in Egypt and Colorado. He died in New York City of myocarditis. Dix was an active author of fiction and travel articles in various magazines, as well as travel books, a history of Samuel de Champlain, he served as Literary Editor of The Churchman. In addition, he composed "Musical Critic's Dream", played extensively by John Philip Sousa's band.
Works by Edwin Asa Dix at Project Gutenberg A midsummer drive through the Pyrenees, New York London, G. P. Putnam's sons 1890. Deacon Bradbury: a novel, New York, The Century Co. 1900. Old Bowen’s legacy: a novel, New York, The Century Co. 1901. Champlain, the founder of New France, New York, D. Appleton and company, 1903. Prophet's Landing: a novel, New York, C. Scribner's Sons, 1907. After twenty years, Princeton University Class of 1881. New York, 1901. After twenty-five years, Princeton University Class of 1881. New York, 1906. Bulletin of class news, Princeton University Class of 1881. New York, 1908. Dix Clemens Family Archive James Richard Joy, Thomas Joy and His Descendants in the Lines of His Sons Samuel of Boston, Joseph of Hingham... printed, 1900. Page 150. Works by Edwin Asa Dix at Project Gutenberg Works by or about Edwin Asa Dix at Internet Archive
Odostomia vicola is a species of sea snail, a marine gastropod mollusk in the family Pyramidellidae, the pyrams and their allies. The vitreous shell has an ovate shape, its length measures 2.5 mm. The whorls of the protoconch are large immersed in the first of the succeeding turns, above which the tilted edge of the last volution only projects, marked by five slender spiral threads; the five whorls of the teleoconch are rounded on all but the first whorl. They are marked by broad, retractive axial ribs, of which 16 occur upon the second and third and 20 upon the penultimate turn. In addition to the axial ribs the whorls are marked by four broad, low spiral cords, which are separated by mere incised lines between the sutures; this renders their junction with the axial ribs strongly nodulous. The sutures are constricted; the periphery of the body whorl is marked by a strong, well rounded spiral cord. The base of the body whorl is decidedly attenuated, it is marked by seven subequal spiral cords, the spaces between which are marked by numerous slender, axial threads.
The aperture is elongate-ovate, decidedly effuse anteriorly. The posterior angle acute; the outer lip is thin, showing the external sculpture within. It is rendered sinuous by the spiral cords; the columella is long, moderately strong, somewhat sinuous, reinforced by the base, provided with a fold at its insertion. The type species was found in the Pacific Ocean off California. ITIS