General Spectrum of Activity

General Spectrum of Activity

Clindamycin is not adequate for empiric therapy for Staphylococcal infections due to increased resistance. Given its association with C difficile colitis, its use should be limited to severe group A Strep sepsis.

It has an adjunctive antitoxin effect also, where it decreases ribosomal toxin production, and can lead to faster clinical improvement for streptococcal infections, like non-purulent cellulitis, necrotizing infections, and streptococcal toxic shock.

Gram positive

  • MSSA
  • Susceptible MRSA (~2/3 of isolates at Billings Clinic)
  • Group A,B,C,G Streptococci (but increasing resistance)
  • Viridans Streptococci

Gram negatives

  • Essentially no aerobic gram negative coverage


  • Increasing resistance in Bacteroides fragilis (do not use for gut anaerobes)
  • Covers many oral anaerobes


  • Pneumocyctis jiroveci
  • Malaria
  • Toxoplasma

Does not cover

  • Almost all aerobic gram negatives
  • Enterococci