Effects of topical clindamycin on intestinal microflora in patients with acne.
Thirty-two patients with acne completed a randomized, double-blind study using topical 1% clindamycin phosphate or its vehicle applied twice daily for 8 weeks for a study of its effects on the intestinal microflora. Two clindamycin patients and one vehicle patient had Clostridium difficile in stools prior to therapy. Of the remaining twenty-nine patients, four of nineteen patients who used clindamycin and none of ten patients who used vehicle had C. difficile detected during treatment; the difference was not statistically significant. There was no diarrhea in the clindamycin group, even though clostridial cytotoxin was found transiently in two patients. Self-limited diarrhea occurred in one vehicle-treated patient, whose stool culture was negative but whose stool specimen showed a positive reaction for C. difficile cytotoxin. With the use of a bioassay, clindamycin was not detected in urine or stool of any patient. No significant changes in Bacteroides fragilis counts in stools were observed in either group.
D000152:Acne Vulgaris / Q000188:drug therapy* / Q000382:microbiology; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000032:analysis; D001441:Bacteroides fragilis / Q000187:drug effects; D002981:Clindamycin / Q000008:administration & dosage / Q000378:metabolism / Q000494:pharmacology*; D003013:Clostridium / Q000187:drug effects*; D005243:Feces / Q000382:microbiology; D006801:Humans; D007408:Intestinal Absorption; D007422:Intestines / Q000382:microbiology*
D001426:Bacterial Proteins; D001427:Bacterial Toxins; C031815:toxB protein, Clostridium difficile; D002981:Clindamycin