Clindamycin prescribing patterns in a university hospital

A study was conducted at a university hospital to determine the patterns of clindamycin prescribing, to assess the appropriateness of clindamycin usage and to quantitate the drug's toxic reactions. Three evaluators (two pharmacists and a physician) reviewed clindamycin usage data for 65 patients who received 67 courses of clindamycin therapy during the period January 1, 1975, through March 20, 1975. Forty-eight courses were parenteral, three oral, and 16 a combination of parenteral and oral. Fifty-four courses were intended for therapeutic use rather than prophylactic use. Of these 54 therapeutic courses, 23 were considered rational and 26 irrational; insufficient data existed to make a judgment in five cases. Three adverse reactions (diarrhea in each case) were observed. The time relationship of this study with the changing clinical status of clindamycin is discussed. Identification of clindamycin's toxicity appears to have reduced oral use at the study hospital, but parenteral usage of the drug remains high.