Colitis associated with clindamycin therapy

Clindamycin (7-chloro-7-deoxylincomycin) may induce mild or severe colitis. In 28 months, clindamycin-associated diarrhea was encountered in 8 patients who had received oral therapy. Severe, acute colitis was seen in 4 older patients, 3 of whom had acute pseudomembranous colitis and one who had an adynamic ileus mimicking an acute abdomen. Mild colitis with protracted diarrhea occurred in 4 younger patients who had mild, nonspecific inflammation in the rectum which responded to symptomatic treatment. The mechanism and true incidence of diarrhea as a sequel of clindamycin therapy are unknown. In all 8 patients, the use of clindamycin was arbitrary. Because of potentially serious gastrointestinal disturbance, including acute pseudomembranous colitis, clindamycin should be reserved for anaerobic and other serious infections.