클린다마이신

린코사마이드계 항생제Highly Important

클린다마이신은 수의학에서 널리 사용되는 광범위 **린코사마이드계 항생제**입니다. 많은 혐기성 세균, 그람 양성 호기성 구균(포도상구균 및 연쇄상구균 등) 및 특정 원충(톡소플라즈마, 네오스포라, 바베시아 등)에 매우 효과적입니다. **임상 요점:** * **우수한 조직 침투력:** 뼈, 활액, 농양 및 백혈구에서 높은 농도에 도달하므로 **골수염**, **치과 감염** 및 **심재성 농피증**의 1차 선택약입니다. * **톡소플라즈마증:** 개와 고양이의 임상적 톡소플라즈마증에 대한 주요 치료제입니다. * **초식동물 독성:** 치명적인 클로스트리듐성 장염의 위험이 있으므로 후장 발효 동물(말, 토끼, 설치류) 및 반추동물에게는 절대 금기입니다. * **식도 협착 위험:** 고양이의 경우 캡슐이나 알약을 물 없이 먹이면 심각한 식도염과 협착을 유발할 수 있습니다. 경구용 고형제 투여 후에는 반드시 물이나 음식을 함께 먹여야 합니다.

작용 기전: Clindamycin acts by binding to the **50S ribosomal subunit** of susceptible bacteria. * **Mechanism:** It inhibits peptide bond formation (transpeptidation) → blocks bacterial protein synthesis. * **Effect:** It can be either **bacteriostatic** or **bactericidal**, depending on the drug concentration at the infection site and the specific susceptibility of the organism. * **Resistance:** Complete cross-resistance occurs between clindamycin and lincomycin, and partial cross-resistance occurs with macrolides (like erythromycin) due to overlapping ribosomal binding sites.

동물 종별 용량

Cats

Susceptible bacterial infections · 5-10 mg/kg · PO · q12h
Infected wounds, abscesses and dental infections · 11-33 mg/kg · PO · once a day (q24h) · Maximum 14 days · Do not treat acute infections for more than 3-4 days if no clinical response is seen.
Sepsis · 11 mg/kg · IV · q12h
Anaerobic infections · 5-10 mg/kg · PO, IV · q12h
Intra-abdominal sepsis · 5-11 mg/kg · IV, SC, PO · q8-12h · 5-7 days · Combined with gentamicin or a parenteral 3rd generation cephalosporin or enrofloxacin
Pancreatitis · 5-11 mg/kg · IV, SC, PO · q8-12h · 3-5 days
Susceptible respiratory infections · 10-15 mg/kg · PO, SC · q12h
Surgical prophylaxis for gram-positive aerobes and anaerobic coverage · 5-11 mg/kg · PO · once · 16-60 minutes preoperatively
Toxoplasmosis (to decrease zoonotic risk by reducing shedding period) · 25-50 mg/kg · PO · daily
Clinical toxoplasmosis · 10 mg/kg · PO · q12h · at least 28 days · Institute supportive care as needed.
Enteroepithelial toxoplasmosis · 8-16 mg/kg · PO, SC · q8h · 14-28 days

투여 경로

POIMIVSCtopical

금기

Horses
Rabbits
Hamsters
Chinchillas
Guinea pigs
Ruminants
Patients hypersensitive to lincosamides
Neonatal small animals (generally avoided)
Known hypersensitivity to lincosamides

이상반응

Gastroenteritis (emesis, loose stools, bloody diarrhea)
Esophageal injuries (esophagitis, strictures) in cats if dry-pilled
Hypersalivation or lip smacking in cats after oral administration
Pain at IM injection site
Mild, clinically insignificant increases in liver enzymes (AST, ALT, ALP)
Colitis
Vomiting
Diarrhoea
Oesophagitis (especially in cats)
Oesophageal stricture (especially in cats)

약물 상호작용

Cyclosporine · Clindamycin may reduce cyclosporine levels
Erythromycin · In vitro antagonism when used with clindamycin; concomitant use should probably be avoided
Neuromuscular blocking agents (e.g., pancuronium) · Clindamycin possesses intrinsic neuromuscular blocking activity and should be used cautiously with other neuromuscular blocking agents
Non-depolarizing muscle relaxants (e.g., tubocurarine) · May enhance the neuromuscular blocking effect · major
Neostigmine · May antagonize the effects of neostigmine · moderate
Pyridostigmine · May antagonize the effects of pyridostigmine · moderate
Macrolides (e.g., erythromycin) · Antagonistic antimicrobial effects due to competing binding sites · major
Chloramphenicol · Antagonistic antimicrobial effects due to competing binding sites · major
Other lincosamides · Antagonistic antimicrobial effects · major
Tubocurarine (and other non-depolarizing muscle relaxants) · May enhance the neuromuscular blocking effect · moderate
Lincomycin · Complete cross-resistance and antagonistic effect · major

모니터링

Clinical efficacy
Adverse effects; particularly severe diarrhea
Periodic liver and kidney function tests and blood counts if therapy persists for more than 30 days
Gastrointestinal signs (vomiting, diarrhoea)
Hepatic and renal function in patients with pre-existing impairment

과용량

There is little information available regarding overdoses of this drug. * In dogs, oral doses of up to **300 mg/kg/day** for up to one year did not result in toxicity. * Dogs receiving **600 mg/kg/day** developed anorexia, vomiting, and weight loss.

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