Clindamycin is highly active against staphylococci and streptococci other than enterococci. Also, clindamycin has significant antibacterial activity against S. pyogenes (group A strep). However, the adverse reaction of pseudomembranous colitis has limited its use to individuals who are unable to tolerate other antibiotics and to the treatment of penicillin-resistant anaerobic bacterial infections. Clindamycin has shown excellent activity topically against Corynebacterium acnes in patients with recalcitrant cystic facial acne who cannot tolerate tetra-cyclines. Precautions should be given to all patients using the topical preparations, since the development of colitis is possible.
Both clindamycin and choramphenicol have excellent activity against anaerobic bacteria but have potentially life-threatening adverse reactions and should not be used without good justification.
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