Aclin

Description

Aclin Capsule, containing the active ingredient Clindamycin, is an antibiotic used to treat a variety of bacterial infections.

Uses of Aclin Capsule

Aclin Capsule is prescribed for:

• Dental Infections
• Respiratory Tract Infections
• Skin and Soft Tissue Infections
• Peritonitis
• Acne
• Anaerobic Infections: Infections caused by bacteria that thrive without oxygen.
• Endocarditis: Used for prophylaxis (prevention) of bacterial endocarditis.
• Toxic Shock Syndrome
• Bacterial Vaginosis
• Pelvic Inflammatory Disease

Dosage Information

The dosage of Aclin Capsule varies based on the type and severity of infection, as well as the patient’s age. It can be taken orally or administered intravenously.

Adult Dosing

Oral Administration:

• Serious Anaerobic Infections: 150-300 mg every 6 hours. For severe infections, the dose can be increased up to 450 mg every 6 hours.
  • Maximum daily dose: 1.8 grams.
• Prophylaxis of Endocarditis: 600 mg taken 1 hour before a dental procedure.
• Bacterial Vaginosis: 300 mg orally every 12 hours for 7 days.

Intravenous (IV) Administration:

• Serious Anaerobic Infections: 0.6-2.7 grams per day, administered in divided doses. For severe infections, the dose can be increased up to 4.8 grams per day.
• Toxic Shock Syndrome: 900 mg every 8 hours, used in combination with penicillin G or ceftriaxone.
• Pelvic Inflammatory Disease: 900 mg every 8 hours, used in combination with gentamicin.

Child Dosing

• Neonates (less than 1 month old): 15 to 20 mg/kg/day, divided into 3 to 4 equal doses. Lower effective dosages may be sufficient for small premature infants.
• Children (Oral):
  • 10–25 mg/kg/day every 8 hours.
  • For Community-Acquired MRSA (CA-MRSA), intra-abdominal infection, or Acute Otitis Media (AOM): 30–40 mg/kg/day.
• Children (Parenteral – IV/IM): 20–40 mg/kg/day every 8 hours. Higher doses are used for more severe infections.

Renal Dosing

• Specific dose adjustments for renal impairment are not provided, but precautions regarding renal disease are noted. Regular monitoring of kidney function is advised.

Administration Guidelines

• Capsules: May be taken with or without food. Swallow the capsule whole with a full glass of water, and remain in an upright position after taking it.
• Granules (for oral suspension): Should be taken with food.

IV Preparation:

• Dilute 300 mg and 600 mg doses in 50 mL of D5W (5% Dextrose in Water).
• Dilute 900 mg doses in 50-100 mL of D5W.
• Dilute 1200 mg doses in 100 mL of D5W.

IV Administration:

• Intermittent IV Infusion: Infuse over 10-60 minutes at a rate not exceeding 30 mg/min.
  • 300 mg doses infuse over 10 minutes.
  • 600 mg doses infuse over 20 minutes.
  • 900 mg doses infuse over 30 minutes.
  • 1200 mg doses infuse over 60 minutes. No more than 1200 mg should be given by IV infusion in 1 hour.
• Continuous IV Infusion: May be used after the first dose has been given by rapid IV infusion.

Important Considerations

Contraindications

Do not use Aclin Capsule if you have:

• Known hypersensitivity to clindamycin or lincomycin.

Precautions

Use with caution in patients with:

• Renal and hepatic diseases: Regular monitoring of liver and kidney functions is recommended.
• Gastrointestinal (GI) disease.
• Pregnancy and lactation.
• Elderly patients, females, neonates, and atopic patients.

Pregnancy and Lactation

• Lactation: Clindamycin is excreted in breast milk. The manufacturer suggests discontinuing the drug or avoiding nursing. However, the American Academy of Pediatrics (AAP) Committee states it is generally compatible with nursing.

Drug Interactions

Aclin Capsule can interact with other medications, potentially altering their effects:

• May enhance the action of neuromuscular blocking agents (e.g., atracurium).
• May antagonize the effects of parasympathomimetics.
• May competitively inhibit the effects of macrolides, ketolides, streptogramins, linezolid, and chloramphenicol.
• Increased coagulation tests (prothrombin time/INR) and/or bleeding may occur with vitamin K antagonists (e.g., warfarin, acenocoumarol, fluindione).

Adverse Effects

Common side effects often involve the gastrointestinal system. Seek medical attention if you experience severe or unusual side effects.

Common:

• Diarrhea, nausea, vomiting, abdominal pain.
• Erythema multiforme, contact dermatitis, exfoliative and vesiculous dermatitis, urticaria.
• Eosinophilia.
• Local irritation, thrombophlebitis (with IV administration).

Potentially Fatal:

• Gasping syndrome (in neonates, associated with benzyl alcohol preservative in some IV formulations).
• Pseudomembranous colitis: A severe form of diarrhea caused by Clostridium difficile, which can occur with nearly all antibacterial agents, including clindamycin.

Mechanism of Action

Clindamycin inhibits bacterial protein synthesis by reversibly binding to the 50S ribosomal subunit of susceptible organisms. This binding blocks the transpeptidation or translocation reactions necessary for protein synthesis, ultimately leading to stunted bacterial cell growth.

Manufacturer Information

Aclin 300mg Capsule is manufactured by Apple International Pharmaceuticals Pvt. Ltd. Its generic name is Clindamycin. Aclin is available in Nepal.