How much does clindamycin cost. What factors affect its price. Are there ways to save on this antibiotic. What forms and strengths are available. How do generic and brand-name versions compare in cost.

Understanding Clindamycin: A Versatile Antibiotic

Clindamycin is a powerful antibiotic used to treat various bacterial infections and acne. As a member of the macrolide antibiotic class, it offers versatility in both its applications and available forms. But what exactly makes clindamycin such a valuable medication in the healthcare landscape?

Clindamycin’s effectiveness stems from its ability to inhibit bacterial protein synthesis, effectively stopping the growth and spread of harmful bacteria. This mechanism of action makes it suitable for treating a wide range of infections, from skin and soft tissue infections to more severe conditions like pneumonia and bone infections.

Available Forms of Clindamycin

• Oral capsules and liquid solution
• Intravenous (IV) or intramuscular injection
• Topical foam, gel, liquid solution, and lotion
• Vaginal suppository and cream

The variety of forms allows healthcare providers to tailor treatment to specific conditions and patient needs. For instance, topical formulations are ideal for treating acne or localized skin infections, while oral or injectable forms are more suitable for systemic infections.

Factors Influencing Clindamycin Cost

The cost of clindamycin can vary significantly depending on several factors. Understanding these can help patients and healthcare providers make informed decisions about treatment options. What are the primary factors affecting clindamycin’s price?

• Treatment plan and duration
• Insurance coverage
• Chosen pharmacy
• Form and strength of the medication
• Generic vs. brand-name versions

For injectable forms of clindamycin, additional costs may include the healthcare professional’s fees for administering the medication. It’s crucial to consider these factors when estimating the overall cost of treatment.

Comparing Clindamycin Strengths

Clindamycin oral capsules are available in 150 mg and 300 mg strengths. While one might assume that the higher strength would always be more expensive, this isn’t necessarily the case. Pricing can vary based on factors such as manufacturing costs, supply and demand, and pharmacy pricing strategies.

To get an accurate comparison of prices between different strengths, it’s best to consult with a pharmacist or check with multiple pharmacies. They can provide current pricing information based on your specific prescription and insurance coverage.

Generic vs. Brand-Name Clindamycin: Cost Considerations

When it comes to medications, the choice between generic and brand-name versions can significantly impact cost. How does this apply to clindamycin?

Clindamycin is available as a generic medication, which is typically more affordable than its brand-name counterparts. The generic versions, referred to as clindamycin hydrochloride or clindamycin phosphate, contain the same active ingredient and are considered equally safe and effective as the brand-name versions.

Brand-Name Versions of Clindamycin

• Cleocin
• Cleocin T
• Evoclin
• Clindesse

While brand-name medications often come at a premium price, some patients or healthcare providers may prefer them for specific reasons. It’s essential to discuss the options with your doctor and check with your insurance provider, as coverage may vary between generic and brand-name versions.

Strategies for Reducing Clindamycin Costs

While clindamycin isn’t typically used as a long-term medication, there are still ways to potentially reduce its cost, especially for treatments lasting several months. What strategies can patients employ to make clindamycin more affordable?

Obtaining a 90-Day Supply

For extended treatments, asking your doctor about a 90-day supply could be beneficial. This approach may reduce the number of pharmacy visits and potentially lower the overall cost. However, it’s crucial to check with your insurance provider first, as not all plans cover extended supplies of antibiotics.

Exploring Mail-Order Pharmacy Options

Mail-order pharmacies can offer convenience and potential cost savings. Some Medicare plans and private insurance providers offer coverage for mail-order medications, which could include the option for a 90-day supply. This method not only saves trips to the pharmacy but may also result in lower copays or medication costs.

Utilizing Pharmacy Discount Programs

Many pharmacies offer discount programs or loyalty cards that can help reduce the cost of prescriptions, including antibiotics like clindamycin. These programs are often free to join and can provide significant savings, especially for those without insurance or with high deductibles.

Financial Assistance and Coupon Options for Clindamycin

For patients struggling with the cost of clindamycin, several financial assistance options may be available. How can patients access these resources?

Manufacturer Coupons and Savings Programs

Some pharmaceutical companies offer coupons or savings programs for their medications, including brand-name versions of clindamycin. These programs can significantly reduce out-of-pocket costs for eligible patients. Check the manufacturer’s website or ask your healthcare provider about available programs.

Patient Assistance Programs

Non-profit organizations and some pharmaceutical companies offer patient assistance programs to help individuals who cannot afford their medications. These programs often have specific eligibility criteria based on income and insurance status.

State Pharmaceutical Assistance Programs

Some states offer pharmaceutical assistance programs to help residents cover the cost of prescription medications. Eligibility and covered medications vary by state, so it’s worth checking with your state’s health department for more information.

Comparing Clindamycin Costs Across Different Forms

The cost of clindamycin can vary significantly depending on the form prescribed. Understanding these differences can help patients and healthcare providers make informed decisions about treatment options. How do the costs compare across different forms of clindamycin?

Oral Formulations

Oral capsules and liquid solutions are often the most cost-effective forms of clindamycin. Generic versions of these formulations are widely available, which typically results in lower prices compared to other forms.

Topical Formulations

Topical forms of clindamycin, such as gels, foams, and lotions, may be more expensive than oral formulations. However, they often require smaller quantities for treatment, which could balance out the cost over time.

Injectable Formulations

Injectable forms of clindamycin are typically the most expensive, partly due to the additional costs associated with administration by a healthcare professional. These forms are usually reserved for more severe infections or situations where oral antibiotics are not suitable.

Vaginal Formulations

Vaginal creams and suppositories fall somewhere in the middle in terms of cost. Their pricing can vary depending on the specific product and whether it’s available as a generic or brand-name version.

Insurance Coverage and Clindamycin Cost

Insurance coverage plays a crucial role in determining the out-of-pocket cost of clindamycin for patients. How does insurance typically handle coverage for this antibiotic?

Formulary Tiers

Most insurance plans categorize medications into different tiers, with lower tiers having smaller copays. Generic clindamycin is often placed in a lower tier, making it more affordable for patients. Brand-name versions may be in higher tiers with larger copays.

Prior Authorization

Some insurance plans may require prior authorization for certain forms or uses of clindamycin. This process involves the healthcare provider demonstrating the medical necessity of the prescription, which can affect both coverage and cost.

Quantity Limits

Insurance providers may impose quantity limits on clindamycin prescriptions, particularly for topical or long-term use. These limits can impact the overall cost of treatment if additional prescriptions are needed.

Understanding your insurance coverage is crucial for estimating your out-of-pocket costs for clindamycin. It’s advisable to review your plan’s formulary or speak with a representative to understand how clindamycin is covered under your specific plan.

Maximizing Value: Tips for Clindamycin Users

While managing the cost of clindamycin is important, it’s equally crucial to ensure you’re getting the most value from your prescription. What steps can patients take to maximize the effectiveness of their clindamycin treatment while managing costs?

Adherence to Prescribed Regimen

Following your healthcare provider’s instructions precisely is crucial for the effectiveness of clindamycin. Completing the full course of antibiotics, even if you start feeling better, helps prevent antibiotic resistance and ensures the infection is fully treated, potentially avoiding the need for additional medication or treatment.

Proper Storage and Handling

Storing clindamycin correctly helps maintain its effectiveness throughout the treatment period. This is particularly important for liquid formulations and topical products, which may have specific storage requirements.

Monitoring for Side Effects

Being aware of potential side effects and promptly reporting them to your healthcare provider can prevent complications that might require additional treatment or medication, thus avoiding additional costs.

Exploring Combination Therapies

In some cases, particularly for acne treatment, clindamycin may be prescribed alongside other medications. Understanding how these combinations work can help you maximize the benefits of your treatment plan and potentially reduce long-term costs associated with managing chronic conditions.

By focusing on these aspects, patients can ensure they’re getting the most value from their clindamycin prescription, both in terms of health outcomes and cost-effectiveness.

Clindamycin cost, coupons, and more

Clindamycin is a generic drug prescribed for a variety of bacterial infections and acne. The medication is available in several forms. The cost of clindamycin can depend on several factors, such as whether the drug has a savings program.

Clindamycin belongs to the macrolide antibiotic drug class. It’s available as the brand-name drugs Cleocin, Cleocin T, Evoclin, and Clindesse. And it comes in these forms:

• oral capsule and liquid solution
• liquid solution for intravenous (IV) or intramuscular injection
• topical foam, gel, liquid solution, and lotion
• vaginal suppository and cream

Read on to learn about clindamycin and cost, as well as how to save money on prescriptions. If you’d like other information about clindamycin, refer to this article.

As with all medications, the cost of clindamycin can vary. Factors that may affect the price you’ll pay include your treatment plan, your insurance coverage, and the pharmacy you use.

Clindamycin injections are given by a healthcare professional. So, the price of the injections will also depend on the cost of the visit to receive your doses.

To find out what the cost of clindamycin will be for you, talk with your doctor, pharmacist, or insurance provider.

Here are answers to some frequently asked questions about drug cost and clindamycin.

Are there coupons available for clindamycin?

Coupons may be available to help cover the cost of clindamycin. For information on financial support, see the “Financial and insurance assistance” and “Next steps” sections below.

Your doctor or pharmacist may also be able to provide information about coupons for clindamycin.

How do the prices of the 150-mg and 300-mg strengths of clindamycin compare?

It’s possible that the 150-milligram (mg) and 300-mg strengths of clindamycin may differ in price. The oral capsule form of the drug comes in 150-mg and 300-mg strengths. (For a full list of clindamycin forms, see “Does the cost of clindamycin vary based on form?” below. )

Keep in mind that the price you pay for clindamycin depends on numerous factors. These include the treatment plan your doctor recommends, what your insurance coverage is, and which pharmacy you use.

If you’d like to find out the price you’ll pay for the 150-mg or 300-mg strength of clindamycin oral capsules, talk with your pharmacist.

Does the cost of clindamycin vary based on form?

Yes, the cost of clindamycin can vary by form.

Clindamycin comes in a variety of forms, including:

• oral capsules
• oral liquid solution
• liquid solution for intravenous (IV) or intramuscular injection
• topical foam
• topical gel
• topical liquid solution
• topical lotion
• vaginal cream
• vaginal suppository

Clindamycin injections are given by a healthcare professional. So, the price of the injections will also depend on the cost of the visit to receive your doses.

For more information about the cost of clindamycin’s different forms, talk with your pharmacist. They can help determine what price you’ll pay.

Clindamycin is a generic drug that may also be referred to as clindamycin hydrochloride or clindamycin phosphate. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

Clindamycin is available in several brand-name forms: Cleocin, Cleocin T, Evoclin, and Clindesse.

To find out how the cost of a brand-name form compares with the cost of clindamycin, talk with your doctor, pharmacist, or insurance provider.

If your doctor has prescribed clindamycin and you’re interested in using a brand-name form instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance provider, as it may only cover one or the other.

Clindamycin isn’t usually used long term. However, depending on the condition you’re using the drug for, you may use clindamycin for a few months. Keep reading for some ways to reduce long-term drug costs with clindamycin therapy.

Getting a 3-month supply

You may be able to get a 90-day supply of clindamycin. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or insurance provider.

Using a mail-order pharmacy

Clindamycin may be available through a mail-order pharmacy. Using this type of service may help lower the drug’s cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order.

If you don’t have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you.

If you need financial support to pay for clindamycin, consider looking into websites that offer cost resources and information. Two such organizations are:

• Medicine Assistance Tool
• NeedyMeds

These sites can provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services.

Now that you’ve learned about cost and clindamycin, you may still have some questions. Talk with your doctor or pharmacist, who can provide personalized guidance on cost issues related to you and clindamycin. If you have health insurance, you’ll need to talk with your insurance provider to learn the actual cost you would pay for clindamycin.

Here are some other resources you may find helpful:

• Medicare drug coverage. To learn about Medicare coverage for drugs, see these articles about Medicare Prescription Drug Plans, drug coupons and Medicare, and the Medicare drug list.
• Save money. Explore this article for tips on how to save money on prescriptions.
• More details. For details about other aspects of clindamycin, refer to this article.
• Information about your condition. For more information about bacterial infections and acne, see our lists of infection and dermatology articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

brand name list from Drugs.com

Chemical formula: C18h43ClN2O5S
Drugbank ID: DB01190
ATC codes: J01FF01, G01AA10, D10AF01, D10AF51

The information below refers to products available in the United States that contain clindamycin.

Products containing clindamycin

clindamycin systemic

Brand names: Cleocin, Cleocin Pediatric, Cleocin Phosphate, Cleocin HCl, Cleocin Phosphate ADD-Vantage
Drug class: lincomycin derivatives

Clindamycin systemic is used in the treatment of:

• Aspiration Pneumonia
• Babesiosis
• Bacteremia
• Bacterial Endocarditis Prevention
• Bacterial Infection
• Bacterial Vaginosis
• Bone infection
• Deep Neck Infection
• Diverticulitis
• Intraabdominal Infection
• Joint Infection
• Lemierre’s Syndrome
• Malaria
• Pelvic Inflammatory Disease
• Peritonitis
• Pneumocystis Pneumonia
• Pneumonia
• Prevention of Perinatal Group B Streptococcal Disease
• Sinusitis
• Skin or Soft Tissue Infection
• Surgical Prophylaxis
• Toxoplasmosis
• Toxoplasmosis, Prophylaxis

clindamycin topical

Brand names: Cleocin Vaginal, Cleocin T, Clindesse, Clindagel, Clindamax
Drug classes: topical acne agents, vaginal anti-infectives

Clindamycin topical is used in the treatment of:

• Acne
• Bacterial Vaginosis
• Perioral Dermatitis

Multi-ingredient medications containing clindamycin

adapalene/benzoyl peroxide/clindamycin topical

Brand names: Adainzde, Adeinzde Gel
Drug class: topical acne agents

Adapalene/benzoyl peroxide/clindamycin topical is used in the treatment of:

• Acne

adapalene/clindamycin topical

Brand name: Clindap-T

Adapalene/clindamycin topical is used in the treatment of:

• Acne

benzoyl peroxide/clindamycin topical

Brand names: Benzaclin, Duac, Acanya, Onexton, Neuac
Drug class: topical acne agents

Benzoyl peroxide/clindamycin topical is used in the treatment of:

• Acne

benzoyl peroxide/clindamycin/niacinamide topical

Brand names: Onzdeoxia, Inzdeoxia Gel
Drug class: topical acne agents

Benzoyl peroxide/clindamycin/niacinamide topical is used in the treatment of:

• Acne

benzoyl peroxide/clindamycin/niacinamide/spironolactone/tretinoin topical

Drug class: topical acne agents

Benzoyl peroxide/clindamycin/niacinamide/spironolactone/tretinoin topical is used in the treatment of:

• Acne

benzoyl peroxide/clindamycin/niacinamide/tretinoin topical

Drug class: topical acne agents

Benzoyl peroxide/clindamycin/niacinamide/tretinoin topical is used in the treatment of:

• Acne

benzoyl peroxide/clindamycin/sodium hyaluronate topical

Brand name: BenzaClin Carekit
Drug class: topical acne agents

clindamycin/niacinamide topical

Brand name: Deoxia
Drug class: topical acne agents

clindamycin/niacinamide/spironolactone/tretinoin topical

Brand name: Deoxiademtar Gel
Drug class: miscellaneous topical agents

Clindamycin/niacinamide/spironolactone/tretinoin topical is used in the treatment of:

• Acne

clindamycin/niacinamide/tretinoin topical

Brand names: Tardeoxia, Deoxiavar, Deoxiatar Solution
Drug class: topical acne agents

Clindamycin/niacinamide/tretinoin topical is used in the treatment of:

• Acne

clindamycin/tretinoin topical

Brand names: Veltin, Ziana
Drug class: topical acne agents

Clindamycin/tretinoin topical is used in the treatment of:

• Acne

Chemical structure

Chemical structure of clindamycin

See also

Search the entire Drugs. com site for clindamycin

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Experience in the clinical management of mixed infections of the urogenital tract in women | Borovikov I.O., Kutsenko I.I., Rubinina E.R.

The article discusses the experience of managing patients with various infections of the urogenital tract (bacterial vaginosis in combination with urogenital candidiasis and chlamydial infection, bacterial vaginosis during pregnancy). The features of combined forms of urogenital infection in women are presented and treatment options for this pathology are proposed.

Introduction

Growth problem infections sexually transmitted diseases and 010 organs small pelvis is traditional current over last years . Inflammatory diseases of the urogenital tract , caused by pathogenic and conditionally – pathogenic microorganism isms , remain serious problem to connection with possibility developmental severe complications related reproductive 0009 function . In the structure gynecological nosologies they occupy the first place and 9000 9 detected in 60–65% all gynecological patients [1, 2 ]. In present time for infectious diseases diseases female genital organs organs characteristic mixed etiology , erased or asymptomatic clinical picture , high frequency mixed – infections , susceptibility to recurrence [3–5]. Infectious vulvovaginitis may result 0009 reproduction pathogenic or conditional – pathogenic microorganisms which become pathogenic in as a result of imbalance in the ecosystem developed due to which – or diseases or their treatment [6–8]. Etiology vaginitis diverse : Trichomonas vaginalis ( to 10% from numbers vulvovaginitis ), Candida spp. ( to 25%), anaerobic microorganisms ( to 30%), mixed infections (15–20%) [6, 9]. Etiological factor development inflammatory diseases female reproductive system may be optional and obligate 9001 0 anaerobic flora bacterial vaginosis and other gram-positive and gram-negative anaerobic and aerobic bacteria , at this in 20% of cases pathogens detect not fails [10, 11].

Inflammatory diseases quite often occur torpid , without manifestations general 9 0010 intoxication and severe pain syndrome . This leads to late diagnosis and treatment which to 9000 9 series cases not conduct general . All these factors contribute to the formation of various complications at the level 9001 0 necks uterus , uterus and its appendages [12, 13]. Last decade in structure infections lower department genital ways 9 0010 predominant bacterial vaginosis and candidiasis genitals , common characterized recurrent course . Causes relapses varied : incomplete sanitation vagina , poor compliance 90 Dysbiosis vaginal [12-15], unsupervised application antibacterial preparations , endocrine pathology , disorders local mucosal immunity 9000 9 [16, 17]. Has a definite value inadequate contraception ( chemical spermicides , combined 010 hormonal contraceptives means with high estrogen content , violation rules application intrauterine acceptance , immunodeficiency condition , especially at level vaginal epithelium [12, 18, 19].

Except also , infectious pathology urogenital women 0009 in structure maternal morbidity and mortality . Interest in this problem related not only with its frequency but and with possibility of transmission infection fetus perinatal 90 009 losses and morbidity children first days life . Infectious process disturbs physiological course pregnancy , that may be accompanied by its untimely interruption and complicated course 900 09 ( injuries in childbirth , postpartum infectious complications ) [12 , 16, 18, 19].

International and Russian recommendations to treatment bacterial vaginosis and vulvovaginal candidiasis include several 900 10 regimens therapy data diseases [20–22]. While this main goals treatment are considered : clinical recovery ; normalization microbiological indicators ; prevention development complications , associated with pregnancy , postpartum period and 9 0009 performing invasive gynecological procedures procedures . Elimination anaerobic microorganisms achieved s using the use of drugs group 5- nitroimidazole or clindamycin [20]. Of the systemic antimycotics the most common and effective on today day recognized fluconazole [23]. Most difficult in choice therapy bacterial vaginosis represent pregnant women women , so not less than
topical application clindamycin phosphate during II–III trimesters gestation not contraindicated [20–21], a 923

With taking into account the above the purpose of this work is to evaluate clinical experience various variants reference women with urogenital infections infections .

Material and methods

Conducted analysis therapy 32 patients with mixed form urogenital infection ( combination bacterial vaginosis and vulvovaginal candidiasis ), 31 patients with co-infection urogenital tract vaginosis and chlamydial infection ) and 28 at term gestation 28–36 weeks . with diagnosed bacterial vaginosis . Studies conducted at department obstetrics , gynecology and perinatology FGBOU VO “ Kuban State Medical University ” Ministry of Health Russia women’s consultations g Krasnodar . All women were examined according to order No. 572 n from 900 09 12.11.2012
Ministry of Health Russian Federation .

Condition of vaginal microflora was assessed according to unified scheme 9 0009 Heerlen with classification results to E . F . Kire (2011) [12]. For detection C. trachomatis method polymerase chain reaction was used ( PCR ). Assessment of the condition of the microbiota of the urogenital tract performed with using PCR with detection results in mode real time time F e moflor -16 010 well a), diagnostics infection with various species Candida spp. — with with direct microscopy , inoculation with isolation pure culture 9000 9 and Final Identification Exciter ( System API 20 C Aux BioMerieux , France ). Quantity score urogenital biota was carried out in absolute and relative indicators . Absolute indicator amount initial deoxyribonucleic acid ( DNA ) calculated 9001 0 method direct comparison graphs accumulation ( Wed ). In absolute values ​​ expressed the following indicators : total bacterial M ), content Myc o pl a sma h o minis, Ur ea plasma spp. (ur ea lyticum + parvum), C a ndida spp. Diagnostic significant indicator for Mycoplasma hominis, Ureaplasma spp. was adopted equal to 10 ⁴ GE / ml , Candida spp. — 10 ³ GE / ml . For quantitative assessment normoflora and conditionally – pathogenic microflora ( UPM ) used relative indicators , which calculated as difference logarithms to base 10 to formula : log ₁₀ (-)=log ₁₀ x – log ₁₀ y . Relative index normoflora represented difference logarithms , obtained for general bacterial mass and normoflora . At this value the difference >1 was regarded as a decrease in normoflora as significant 9 0009 . and 9 specific microorganism and in norm must be not less than 90 009 3. Analysis results laboratory conclusions allows to take into account mutual content ( share ) normoflora and UPM . C target grade share content normal flora and UPM calculated the sum of all isolated microorganisms . For objectification received data and convenience interpretation results share 900 10 normoflora and UPM calculated as percentage ratio absolute of its amount to sum 9 0010 all isolated microorganisms .

The results of examinations were processed by the method of variation statistics with definition criteria Fisher (F) for estimates non-parametric indicators groups small 9 0010 samples and Student’s tests (t) for independent groups . Analysis was carried out with using the program Statistica 6.0.

Results and discussion

Mixed form of urogenital infection (bacterial vaginosis + vulvovaginal candidiasis) in non-pregnant women

Observed and were examined 32 women at aged from 18 to 38 years ( average age — 28.1±3.6 years ) at diagnosed mixed urogenital infection ( combination bacterial vaginosis and vulvovaginal candidiasis ). about vulvovaginal candidiasis was registered primary treatment ( acute vulvovaginal candidiasis ). All patients , included in sample , in that or other 90 009 degree had certain clinical manifestations ( fig . 1 ). Prevailed complaints against allocations out of genital ways in increased amount 010 curdled » character with unpleasant odor , subjective sensations in sight itching , burning , pain with urination , soreness sexual act ( dyspareunia ).

objective examination changes of mucous membranes were noted characteristic for vulvovaginitis 9000 9 ( swelling , hyperemia mucous vagina and vulva , sometimes ulceration and fissures in area external genital organs ), maceration 900 10 genital lips and anogenital zone .

Vaginal microscopic picture morphotypes microorganisms corresponded to the concept of vaginal dysbiosis . Normal number lactobacilli detected only in 9.4% cases , in 9001 0 this conditionally – pathogenic microflora in mainly was is represented by Gardnerella vaginalis, Mobiluncus spp. and Bacteroides spp. — 93.7%, 78.1% and 43.7% respectively ( fig. . 2).

Also prevailed coccal microflora ( in total 87.5%). Evaluation signs bacterial vaginosis according to method Nugent (1991) detected 90 010 in 100% cases 7–10 points ( bacterial vaginosis ).

In accordance with criteria NCCLS isolated strains C. albicans were found to be the most susceptible 900 09 to fluconazole . C. glabrata, C. tropicalis, C. parapsilosis and C. krusei developed self over resistant to modern antimycotics , but , considering their small sample , results are considered unrepresentative ( tab. . 1).

On the basis of clinical – microbiological examination this contingent patients was prescribed complex therapy including topical application clindamycin phosphate 9000 9 ( Dalacin ® (Pfizer Inc., USA) — vaginal suppositories 100 mg 1 r ./ days № 3) and oral fluconazole 150 mg ( Diflucan 90 009® (Pfizer Inc. , USA)) No. 1 ( single in first day therapy clindamycin ). Selection of the above drugs was carried out in accordance with with international and Russian recommendations for treatment bacterial vaginosis and vulvovaginal candidiasis [20–22].

Clinical cure at examination after 14 days after completion of therapy 9 0010 amounted to 93.7%, other 6.3% patients recorded significant improvement of ( fig. . 3).

After 30 days cure ( no symptoms

mixed infection urogenital tract ) detected in 90.6% women . At this frequency recurrence ( ineffectiveness therapy ) at this term monitoring was 3.1%. After 60 days monitoring frequency clinical relapses was 6.3%. Microbiological efficiency on data terms observation was respectively , 87.5–84.4 -75.0%. With this patient with grade grade bacterial vaginosis 7–10 points by Nugent 900 09 after 14 days from start of therapy absent , a through 1 and 2 months . their number of was 6.3%.

So way , conducted clinical study showed high efficiency combined use clindamycin and fluconazole in therapy mixed forms urogenital infection .

Mixed form of urogenital infection (bacterial vaginosis + chlamydial infection) in non-pregnant women

Observed 31 female at age from 19 to 32 years ( middle age — 25.4±4.1 ), y which was diagnosed mixed form urogenital infection ( combination bacterial vaginosis 900 09 and chlamydial infection ). In the clinical picture there were complaints of “ mucosal – purulent ” 9001 0 excretion from genital tract with unpleasant odor , itching in area genital organs pain during sexual intercourse and urination ( fig . 4).

Analysis of the vaginal microbiota revealed , except the presence of C. trachomatis against the background reduction number of lactobacilli , sufficient frequent presence M. genitalium (61.3%), Ur ea plasma spp. (35.5%) and gardnerella (83.9%) ( fig . 5). Assessment signs bacterial vaginosis Nugent detected in 90.3% 7– 10 points ( bacterial vaginosis ).

Completed complex therapy , including topical application clindamycin phosphate ( Dalacin ® vaginal suppositories 100 mg 1 r ./ days No. 3) and trans – oral azithromycin according to regimen (1- and day 500 mg , 2-5- and days to 250 mg ). Through 2 weeks . after completion of therapy clinical cure ( no symptoms symptoms mixed infection 90 009 urogenital tract ) detected in 90.3% patients , failure of therapy registered only in 1 case (3.2%) ( fig . 6). Through 1 and 2 months . cure was , respectively , 83.9 and 74.1%.

Microbiological efficiency on data observation time was respectively 0009, 83.9–80.6–74.2%. With this patients with assessment degree bacterial vaginosis 7–10 9001 0 points to Nugent through 14 days from start therapy was absent , and through 1 and 2 months . their number was 9.7%.

Bacterial vaginosis in pregnancy

treated 28 pregnant women women with bacterial vaginosis in term 900 09 gestation 28–36 weeks . In the clinical picture complaints of discharge prevailed of genital tracts with unpleasant odor , in complaints missing . gynecological examination revealed signs of vaginitis and cervicitis 900 09 (57.1%). Microbiological examination method PCR – RV paid self attention low content lactoflora (10.7%) and predominance anaerobic microflora .

as basic therapy selected vaginal cream 2%, containing in 1 g 20 mg clindamycin phosphate ( Dalacin ® cream 90 010 vaginal 100 mg / days No. 7 – 1 applicator (5 g ) – 100 mg clindamycin ). Treated concurrent candidiasis treated with polyene macrolide ( natamycin ) ( intravaginally in dose 100 mg 1 r ./ days in 90 009 within 6 days ). as a follow-up decontamination therapy topical treatment with eubiotic , containing not less than 100 ppm Lactobacillus acidophilus ( to 1 suppository to night intravaginally beyond 3 days to start pre-induction to during 6 days ). All The above preparations allowed to Use at II – III trimesters Pregnancy .

Microbiological monitoring effectiveness therapy was carried out after 7 days after completion treatment .

On background ongoing decontamination and subsequent contamination therapy at patients registered increase number of lactobacilli ( to 92.8%), decrease number of 9001 0 gardnerell ( from 82.1% to 7.1%) , leveling Mobiluncus spp. and Veillonella spp.;0009 microflora ( fig . 7).

Conclusion

In during the study conducted in patients with various forms of infections urogenital tract detected high efficiency local therapy 9 bacterial vaginosis antibacterial – clindamycin phosphate 0009 can be used during II and III trimesters pregnancy ), in as antimycotic therapy not loses its relevance and efficacy systemic antifungal drug fluconazole .

Information about authors : Borovikov 900 09 Igor Olegovich – d . m . n ., Associate Professor Department of Obstetrics , gynecology and perinatology ; Kutsenko Irina Igorevna – d . m . n ., Professor , Head Department Obstetrics , Gynecology and Perinatology 900 09; Rubinina Edita Rubenovna — graduate student Department of Obstetrics , gynecology and perinatology . FGBOU VO Kuban State Medical University Ministry of Health Russia . 350063, Russia , g . Krasnodar , street . Sedina , d . 4. Contact information : Borovikov Igor Olegovich , e-mail: [email protected]. Transparency financial activities : none of authors no has financial interest in provided materials and methods . Conflict interests absent . Article received on 07/24/2018.

About the authors: Igor O. Borovikov — MD, AP of the Department of Obstetrics, Gynecology and Perinatology; Irina I. Kutsenko — MD, professor, Head of the Department of Obstetrics, Gynecology and Perinatology; Edita R. Rubinina – Graduate student. The Department of Obstetrics, Gynecology and Perinatology of Kuban state medical university, Krasnodar, Ministry of Health of Russia. 4, Sedina str., Krasnodar, 350063, Russian Federation. Contact information: Igor O. Borovikov, e-mail: [email protected]. Financial Disclosure: no author has a financial or property interest in any material or method mentioned. There is no conflict of interest. Received 07/24/2018.

New class of synthetic antibiotics described – PCR News

There are two main approaches to the development of new antibiotics that would be effective against antibiotic resistant bacteria. The first approach, semi-synthetic, involves chemical modifications of already known natural antibiotics. The second approach involves obtaining fully synthetic molecules, the structure of which is suggested by nature itself. The authors of the work published in Nature , created a new antibiotic by replacing the structural basis of a molecule from the group of lincosamides – clindamycin.

Lincosamides block the work of the bacterial ribosome. The first antibiotic of this group, lincomycin, was isolated in 1963 from soil bacteria of the genus Streptomycetes. Subsequently, he was forced out of clinical practice by a stronger antibiotic of the same group – clindamycin. Based on it, a semi-synthetic antibiotic was recently obtained, effective against several gram-positive bacteria with multidrug resistance. However, many bacteria have developed resistance to clindamycin due to 23S rRNA methylation by rRNA methyltransferases, which are encoded by genes erm and cfr . The authors of the new work changed the structural backbone of clindamycin by adding its aminooctose residue to the oxepanoproline skeleton. The antibiotic created in this way was named iboxamycin.

The scientists tested iboxamycin on various strains of Gram-positive and Gram-negative bacteria. It turned out to be sensitive to many antibiotic-resistant strains, including those with methyltransferases erm and cfr . Iboxamycin was also effective against antibiotic-resistant pathogens of the ESKAPE group 10 , Klebsiella pneumoniae , Acinetobacter , Pseudomonas aeruginosa and Enterobacter sp.). Scientists have shown that the antibiotic is not toxic to mammalian cells. Studies in mice have confirmed the safety of iboxamycin and its effectiveness against infections caused by a range of antibiotic resistant bacteria.

Why does iboxamycin also act on ribosomes protected by rRNA methylation? Scientists have demonstrated that the antibiotic severely blocks translation immediately at the start codon. Structural studies performed on the ribosomes of the Gram-negative bacterium Thermus thermophilus showed that iboxamycin interacts with the canonical binding site of antibiotics of the lincosamide group on the large subunit. This site overlaps with the catalytic center of the ribosome and protrudes slightly into a tunnel designed to exit the growing polypeptide from the ribosome. Methylation of the A2058 residue in the 23S rRNA is one of the most common mechanisms of resistance to antibiotics of this group in clinical pathogens. Since the molecular contacts of iboxamycin with the binding nucleotide A2058, which is critical for binding in a normal unmethylated ribosome, are no different from the contacts of clindamycin with a ribosome, there was no reason to assume that iboxamycin would bind to methylated ribosomes and, accordingly, suppress the growth of antibiotic-resistant pathogens. However, much to the surprise of the researchers, the predictions were not confirmed. It turned out that, unlike clindamycin, iboxamycin forms powerful hydrophobic interactions with the A site of the ribosome and therefore successfully binds even to ribosomes methylated at the A2058 residue of 23S rRNA. In other words, the powerful hydrophobic interactions of one part of the antibiotic molecule at the A site of the ribosome compensate for the loss of electrostatic contacts in the other part of the antibiotic molecule, which until now were considered absolutely necessary for binding. The authors of the study note that the development of broad-spectrum antibiotics that form potent contacts with the A site may be a new strategy for combating bacteria that are protected from standard drugs by rRNA methylation.

Yuri Polikanov (University of Illinois, Chicago) answered questions from PCR.NEWS.

How do you assess the prospects of iboxamycin in clinical practice?

I think they are quite high, especially since it works quite well in mouse infection models. At the same time, it works against both gram-positive and gram-negative pathogenic bacteria. Obviously, iboxamycin still needs to be optimized chemically. But this is exactly what our colleagues from Harvard are doing, who, in their own words, invented it.

At the end of the article, you write that antibiotics that bind to the A site of the ribosome could be a new strategy to fight bacteria that have managed to acquire rRNA methyltransferases. Do you plan to further investigate antibiotics that are similar in mechanism of action to iboxamycin?

Certainly! You could say that’s all we do. There are a lot of antibiotics that bind to the ribosome A site, and they belong to different unrelated chemical classes, and, of course, we study a lot of them. But here it is important to mention that specifically our laboratory is not engaged in inventing new antibiotics, since we are not chemists. However, we are most interested in them, since our main interest lies in the fundamental understanding of how these antibiotics work at the molecular level and how some of them, such as iboxamycin, are able to bypass the main clinically significant mechanisms of resistance.