MARGARITA GALLEGOS RAMOS

INFECTOLOGA
8 SEMESTRE GRUPO D

Licomicina
Streptomyces
lincolnensis.
1962.
Lincoln, Nebraska.
1966: Clindamicina.
Derivado semisinttico.

Siva Palasingam S. et al. Macrolides, Clindamycin and ketolides. In: Mendell Douglas and Bennett. Principles and
Practice of Infectious Diseases. 7th. Ed. Ed: Churchill Livingstoe Elsevier. Philadelphia PA. USA. 2010: Pags: 427-448.

 Lincomicina

Aminocido

Azcar

Clindamicina
Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert
Pharmacother. 2007; 14: 2401-2444

Opin.

El

clorafenicol,
macrolidos
y
estreptograminas
tambin se unen a
ribosomas
antagonizan
competitivamente
actividad
de
clindamicina.

los Acta a nivel del

ribosoma 50s.
las
los
y
la
la

Interacta con los

sitios A y
P,
previniendo
la
transpeptidacin y
la elongacin.

Inhibe
la
sntesis
de
protenas.

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

1.Modificacin del sitio de unin de la

droga.
-Metilacin del 23s ribososmal del RNA mediada por
los genes erm.

2.Modificacin
de
la
droga
por
enzimas especificas.
-Nucleotrasferasas mediadas por los genes linA.
3.Bombas de eflujo desde el espacio
periplasmtico.
-Mediado por los genes msrA

Formas de presentacin:
Clorhidrato : oral de slidos.
Palmitato: suspensin oral.
Fosfato: parenteral.
Crema vaginal 2% .
vulos vaginales 100mg .

Guay, D. Update on clindamycin in hte management of bacterial, fungal and

protozoal infections. Expert Opin. Pharmacother. 2007; 14: 2401-2444

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections.
Expert Opin. Pharmacother. 2007; 14: 2401-2444

Va de
administracin Dosis
(mg)

Tmax

Cmax
(mg/dl)

Oral

150
300

0.75 h.

2.55
3.44

IM

300

3 h.

IV

600
900
1200

20-45
min

10
11
14

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

No atraviesa SNC.
No
atraviesa
tracto
biliar
obstruido.
No dializable.

Distribucin:
Hueso
-Nios: 30-46%.
-Adultos: 74%.
Abscesos
Macrfagos
alveolares
Clulas rojas
LPN

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

Metabolismo :
Heptico.

Excrecin:
Orina
Bilis

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert
Pharmacother. 2007; 14: 2401-2444

Opin.

Bacteria
Staphylococcus aureus.

MIC 50 (mg/l))
0.1 - 0.25

Staphylococcus epidermidis.

0.1

Streptococcus pneumoniae.

O.O1 - 0.25

Streptococcus pyogenes.

O.O6 - 0.04

Streptococcus viridans.

< 0.06 - 0.12

Corynebacterium diphtheriae.

0.2

Hemophilus influenzae.

12.3

Neisseria meningitidis.

12.5

Neisseria gonorrhoeae.

3.1

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin. Pharmacother.
2007; 14: 2401-2444

Bacterias

MIC 50 (mg/l)

Campylobacter fetus.

<3.1

Peptococcus spp.

0.125

Peptostreptococcus spp.

0.125

Propionibacterium spp.

0.03

Clostridium perfringens.

0.12 - 1

Clostridium tetani.

0.12 - 1

Fusobacterium spp.

0.015 - 16

Bacteroides fragilis.

0.25 - 1

Prevotella spp.

0.06 - 4

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

Bacterias

MIC 50 (mg/l)

Gardnerella vaginalis.

0.5

Mycoplasma pneumoniae.

3.1

Chlamydia trachomatis.

Clostridium ramosum, novyi,

sordelli,
bifermentans, difficile,
sporogenes.

Resistentes

Pseudomonads.

Resistentes

T. pallidum.

Resistente

1-4

>8
Resistentes
Enterococcus
.
Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections.
Expert Opin. Pharmacother. 2007; 14: 2401-2444

Protozoarios
T. gondii.
Babesia spp.
P. falciparum.
Hongos

Pneumocystis jiroveci

Infecciones del tracto

respiratorio:
Sinusitis crnica.
Otitis media.
Absceso pulmonar.
Neumona por aspiracin.
Infecciones pleuropulmonares por
anaerobios.
C. diphtheriae.

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert
Opin. Pharmacother. 2007; 14: 2401-2444

Infecciones del tracto genital

femenino:
Infecciones por clamidia durante el
embarazo.
Enfermedad inflamatoria plvica.
Endometritis puerperal.
Corioamnionitis.
Profilaxis contra estreptococo del
grupo B.

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

 Aborto sptico.
Abscesos de las
glndulas de
Bartholin.
Infecciones
vaginales.
Vaginosis bacteriana.
Mastitis.
Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

Infecciones de
la
piel:
Imptigo, celulitis y erisipela.
Infecciones despus de mordeduras
de animales y humanas.
Infecciones del sitio quirrgico
incisional.
Pie diabtico.
lceras de decbito.
Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

 Sd., shock txico

por estreptococo y
estafilococo.
Fascitis
necrotizante.
Miositis por
estreptococos.
Osteomielitis.
Infecciones
dentales.
Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert
Opin. Pharmacother. 2007; 14: 2401-2444

Infecciones por
hongos:
Neumona por Pneumocystis
jirovenci.
Infecciones por
protozoarios:
Babesiosis.
Malaria.
Toxoplasmosis cerebral.

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

Diarrea
Nuseas
Anorexia
Exantemas
cutneos
Alteraciones de la
funcin heptica
Neutropenia

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal

infections. Expert Opin. Pharmacother. 2007; 14: 2401-2444

Antagonismo
Macrlidos
Clorafenicol
Ciclosporina A
Sinergismo
Bloqueantes
neuromusculares
Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

Compatible Admn., IV

Cloruro de sodio
Potasio
Glucosa
Calcio
Complejo vitamnico B
Gentamicina
Cefalotina

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert Opin.
Pharmacother. 2007; 14: 2401-2444

Incompatible Admn., IV

Ampicilina
Aminofilina
Barbitricos
Gluconato de
calcio
Sulfato de
magnesio
Fenitona

Guay, D. Update on clindamycin in hte management of bacterial, fungal and

protozoal infections. Expert Opin. Pharmacother. 2007; 14: 2401-2444

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert
Pharmacother. 2007; 14: 2401-2444

Opin.

Guay, D. Update on clindamycin in hte management of bacterial, fungal and protozoal infections. Expert
Pharmacother. 2007; 14: 2401-2444

Opin.