Clindamycin vs Amoxicillin

This article reveals the differences between clindamycin and amoxicillin:

Clindamycin

It is a semisynthetic derivative of lincomycin which was introduced in the 1960s. It is an antibiotic that is usually given to treat serious bacterial infections. It can be found under the brand names of Cleocin, Dalacin, and Lincocin.

Amoxicillin

It is an antibiotic that is used to treat infections caused by certain types of pathogenic bacteria. It can be found under the brand names of – Moxatag and Amoxil.

Uses

Clindamycin

It is used to treat tooth infections where other antibiotics have not worked. Also, it is useful for treating bone and joint infections as well as infections in the abdomen.

When given orally, its absorption is not affected by food, and it is absorbed efficiently by the digestive tract. Peak concentrations are found after approximately 45 min.

Amoxicillin

This antibiotic is used for the treatment of:

• nose, ear, and throat infections – pharyngitis/tonsillitis (strep throat), otitis media (middle ear infection), and sinusitis (sinus infection);
• Lyme disease – it is caused by the spirochetal bacterium Borrelia burgdorferi;
• typhoid fever – this antibiotic reduces the risk of the carrier state;
• endocarditis – it is a life-threatening infection of the inner lining of the heart;
• infections of  the urinary tract (kidneys, bladder, ureters, and urethra) and the genital organs (uterus, vagina, fallopian tubes/ovaries);
• postexposure prophylaxis for anthrax – this antibiotic is prescribed to prevent the development of anthrax disease in individuals who have been exposed to anthrax;
• prevention of postoperative oral infections, particularly when multiple avulsions and mandibular third molars are involved;
• lactational mastitis;
• infected ulcers and infected burns;
• impetigo (large vesicles or honey-crusted sores);
• chlamydial infections;
• abscesses;
• carbuncles;
• furuncles;
• folliculitis (inflammation of the hair follicles);
• erysipelas (a superficial form of cellulitis);
• cellulitis (infection of the subcutaneous tissue and dermis);
• Helicobacter pylori infection;
• lower respiratory tract infections, such as – bronchitis, tracheobronchitis, and pneumonia;
• sexually transmitted diseases – gonorrhea.

Mechanism of Action

Clindamycin works by stopping the pathogenic bacteria that are the cause of the infection from multiplying. In addition, it exerts an extended postantibiotic effect against some strains of pathogenic bacteria.

Amoxicillin works by killing the pathogenic bacteria and stopping their growth in the human body.

Side Effects

Clindamycin

The most common adverse events include:

• vaginal discharge or itching;
• stomach pain;
• mild skin rash;
• vomiting;
• nausea.

Serious side effects may include:

• a sore throat;
• abdominal tenderness;
• skin redness, rash, and itching;
• fever;
• pale stools;
• stomach cramps or pain;
• dark urine;
• bloody diarrhea;
• yellowing of the skin or whites of the eyes;
• severe abdominal pain;
• weight loss;
• loss of appetite;
• cuts that don’t stop bleeding;
• diarrhea;
• weight loss;
• bleeding gums;
• stiff neck;
• coughing blood;
• headache;
• blood in the urine;
• prolonged dizziness;
• bruising;
• shortness of breath;
• unusual nosebleeds;
• severe diarrhea;
• chills.

Amoxicillin

Side effects may include:

• a decrease in the quantity of urine;
• trouble passing urine;
• allergic reactions, such as – itching or hives, skin rash, swelling of the lips, face, or tongue;
• yellowing of the eyes or skin;
• breathing problems;
• unusual bleeding or bruising;
• dark urine;
• unusually weak or tired;
• seizures;
• redness, peeling, blistering, or loosening of the skin;
• diarrhea;
• trouble sleeping;
• dizziness;
• headache;
• stomach upset.

Dosage

The usual recommended dose of clindamycin for adults is 150 to 300 mg four times per day.

The usual recommended dose of amoxicillin for bacterial endocarditis prophylaxis is 2 grams orally as a single dose about 60 minutes prior to the procedure.

Warnings & Precautions

Clindamycin

To make sure that this antibiotic is safe for you, tell your healthcare provider if you have ever had:

• an allergy to yellow food dye;
• Crohn’s disease, colitis (a disease that affects the large intestine), or other intestinal disorders;
• a severe allergic reaction to aspirin;
• allergic skin reaction;
• asthma;
• liver disease;
• eczema.

Amoxicillin

To make sure that this antibiotic is safe for you, tell your healthcare provider if you have:

• drug allergies, particularly to a cephalosporin antibiotic like – Cefzil, Ceftin, Omnicef, or Keflex;
• asthma;
• food allergy;
• a history of diarrhea which is caused by taking antibiotics;
• mononucleosis (a contagious illness that is caused by the Epstein-Barr virus);
• kidney disease;
• liver disease.

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Drug Interactions

Clindamycin may interact in a negative way with the following medications:

• sodium picosulfate;
• erythromycin;
• primaquine;
• pancuronium (an aminosteroid muscle relaxant);
• mivacurium;
• doxacurium;
• atracurium;
• mycophenolate.

Amoxicillin may interact in a negative way with the following medications:

• tetracycline (an antibiotic that is used to treat some types of bacterial infections);
• allopurinol (Lopurin, Zyloprim);
• macrolides;
• sulfonamides;
• chloramphenicol;
• probenecid (Benemid).

Alcohol

Alcoholic beverages will not affect the efficacy of these antibiotics. That being said, it is usually good advice to avoid the intake of alcoholic beverages when you are being treated for an acute illness.

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Is It Safe During Pregnancy or Breastfeeding?

Clindamycin antibiotic crosses the placenta and is secreted in small amounts into human milk. Talk to your doctor before taking the antibiotic. Also, it is generally considered safe for use by pregnant women.

Amoxicillin can pass through breast milk and increase the risk of a later allergic reaction in infants. Let your doctor know if you are breastfeeding before taking the antibiotic. In addition, it is believed to be safe during pregnancy.

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Bottom Line – Clindamycin vs Amoxicillin

Clindamycin is a lincosamide antibiotic that has been approved by the US FDA for the treatment of streptococcal, anaerobic, and staphylococcal infections. It is available as phosphate for intravenous or intramuscular injection, as clindamycin hydrochloride for oral administration in capsules, and as palmitate for oral suspensions. It is commonly used before dental surgery or procedures to prevent infections in individuals who have heart issues, which puts them at greater risk of infection.

Amoxicillin is a semisynthetic aminopenicillin antibiotic structurally related to ampicillin. It is found as an oral tablet as well as a suspension and a capsule. It is used to treat a variety of infections that are caused by pathogenic bacteria, like:

• infections of the throat, skin, ear, nose, or urinary tract;
• gonorrhea;
• pneumonia;
• bronchitis;
• tonsillitis.

According to a 2012 study published in NCBI, oral amoxicillin given prior to dental extraction generated a substantial reduction in post-extraction bacteremia in study participants.

The use of prophylaxis with clindamycin is recommended for the prevention of bacteremia following dental extractions in patients with high risk of bacteremia and with an allergy to penicillin, as per a 2006 study done at the School of Medicine and Dentistry, Santiago de Compostela, Spain. However, amoxicillin continues to be the antibiotic of choice for in the prevention of bacteremia following dental extractions and for people who are not allergic to penicillin.

Image credit – Shutterstock

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Sources

https://bmjopen.bmj.com/content/7/3/e013260
https://www.jaad.org/article/S0190-9622(03)03425-X/fulltext