How much does clindamycin cost. What forms is clindamycin available in. Are there ways to save money on clindamycin prescriptions. Is clindamycin available as a generic or brand-name drug. How can patients reduce long-term costs of clindamycin therapy.

Understanding Clindamycin: A Versatile Antibiotic for Various Infections

Clindamycin is a powerful antibiotic medication used to treat a wide range of bacterial infections and acne. As a member of the macrolide antibiotic drug class, it offers versatility in its applications and forms of administration. Healthcare providers prescribe clindamycin for its effectiveness against many types of bacteria, making it a valuable tool in combating infections.

Available Forms of Clindamycin

Clindamycin comes in several forms to accommodate different medical needs and patient preferences:

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

This variety allows healthcare providers to tailor the treatment to the specific infection site and patient requirements.

Clindamycin Cost Factors: What Influences the Price?

The cost of clindamycin can vary significantly based on several factors. Understanding these can help patients better navigate their treatment options and potential expenses.

Key Factors Affecting Clindamycin Pricing

• Treatment plan prescribed by the healthcare provider
• Insurance coverage and terms
• Pharmacy selection
• Form and strength of clindamycin prescribed
• Duration of treatment

For injectable forms of clindamycin, additional costs may include the healthcare professional’s fee for administering the medication. Patients should consult their healthcare provider, pharmacist, or insurance company for specific pricing information tailored to their situation.

Generic vs. Brand-Name Clindamycin: Understanding the Differences

Clindamycin is available as both a generic medication and under several brand names. This availability can impact the cost and accessibility of the drug for patients.

Generic Clindamycin

Generic clindamycin, also known as clindamycin hydrochloride or clindamycin phosphate, is an exact copy of the active ingredient found in brand-name versions. It offers the same safety and efficacy as brand-name options, often at a lower cost.

Brand-Name Options

Brand-name versions of clindamycin include:

• Cleocin
• Cleocin T
• Evoclin
• Clindesse

The choice between generic and brand-name clindamycin may depend on factors such as doctor preference, insurance coverage, and individual patient needs. Patients should discuss these options with their healthcare provider to determine the most appropriate and cost-effective choice for their treatment.

Saving on Clindamycin: Coupons, Assistance Programs, and Cost-Reduction Strategies

For patients concerned about the cost of clindamycin, several options exist to potentially reduce out-of-pocket expenses.

Coupons and Savings Programs

Coupons for clindamycin may be available through various sources. Patients can inquire with their healthcare provider, pharmacist, or the drug manufacturer about potential savings opportunities. These coupons can help offset the cost of the medication, making it more accessible for those who need it.

Financial Assistance Programs

Some pharmaceutical companies and non-profit organizations offer financial assistance programs for patients who struggle to afford their medications. These programs may provide the drug at a reduced cost or even free of charge for eligible individuals.

Insurance Considerations

Insurance coverage can significantly impact the cost of clindamycin. Patients should review their insurance plans to understand their coverage for this medication. Some plans may have preferred pharmacies or mail-order options that offer lower copays or coinsurance rates.

Long-Term Cost Management for Clindamycin Therapy

While clindamycin is not typically used for extended periods, some conditions may require longer treatment durations. In such cases, patients can employ several strategies to manage long-term costs effectively.

90-Day Supply Options

Obtaining a 90-day supply of clindamycin, if approved by the insurance provider, can reduce pharmacy visits and potentially lower overall costs. This option may be particularly beneficial for patients using topical forms of clindamycin for acne treatment.

Mail-Order Pharmacy Services

Utilizing mail-order pharmacy services can offer convenience and potential cost savings. Some insurance plans, including certain Medicare plans, may provide coverage for mail-order medications, allowing patients to receive their prescriptions at home while potentially reducing costs.

Comparing Clindamycin Strengths: 150 mg vs. 300 mg

Clindamycin oral capsules are available in 150 mg and 300 mg strengths. The price difference between these strengths can vary based on several factors.

Factors Influencing Strength Pricing

• Prescribed dosage and treatment duration
• Insurance coverage specifics
• Pharmacy pricing structures
• Manufacturer pricing decisions

Patients should consult their pharmacist for specific pricing information on different strengths of clindamycin, as costs can vary significantly between pharmacies and insurance plans.

Navigating Clindamycin Options Without Health Insurance

For patients without health insurance, the cost of clindamycin can be a significant concern. However, several options exist to help manage these expenses.

Strategies for Uninsured Patients

• Discuss generic options with healthcare providers
• Explore patient assistance programs offered by drug manufacturers
• Consider online pharmacy options that may offer lower prices
• Inquire about cash prices at different pharmacies, as they can vary significantly
• Look into community health centers or free clinics that may offer medications at reduced costs

Healthcare providers and pharmacists can often provide guidance on finding affordable options for clindamycin and other necessary medications.

Maximizing the Benefits of Clindamycin While Managing Costs

Clindamycin’s versatility in treating various bacterial infections and acne makes it a valuable medication for many patients. By understanding the factors that influence its cost and exploring available savings options, patients can work with their healthcare providers to find the most cost-effective treatment plan.

Key Takeaways for Clindamycin Cost Management

• Compare prices between generic and brand-name options
• Explore coupons and patient assistance programs
• Consider long-term cost management strategies for extended treatments
• Discuss different forms and strengths with healthcare providers to find the most cost-effective option
• Utilize insurance benefits effectively, including mail-order and 90-day supply options when available

By taking a proactive approach to managing clindamycin costs, patients can ensure they receive the treatment they need while minimizing financial burden. Open communication with healthcare providers and pharmacists is crucial in navigating the complexities of medication pricing and finding the best solutions for individual needs.

As healthcare costs continue to be a concern for many patients, staying informed about medication options and available resources is essential. With the right approach, patients can access effective treatments like clindamycin without undue financial stress, ensuring better health outcomes and peace of mind.

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.