THIS MEDICATION CAN CAUSE HARM TO YOUR BABY:
Clindamycin can be taken during pregnancy if clearly indicated and after the risks versus benefits have been considered. There are limited human studies that have looked at the safety of clindamycin during pregnancy, but animal studies indicate that taking clindamycin during pregnancy is not harmful to the developing baby. It is important to weigh the risks versus benefits of breastfeeding while on clindamycin. Nursing infants exposed to clindamycin through breast milk should be monitored for negative side effects.
What is clindamycin?
Clindamycin is a medication that is taken to treat bacterial infections in children and adults. Clindamycin is currently available as a generic or brand name medication. Clindamycin is available in capsules, intramuscular injection, intravenous, topical, and oral solution and has varying doses based on route of administration (generally given in 2 to 4 doses daily). It is only available by prescription from your doctor.
What is clindamycin used to treat?
Clindamycin is used to treat severe bacterial infections, skin infections, bone and joint infections, abdominal infections, lower respiratory tract infections, acne, bacterial vaginosis, strep throat, and pelvic inflammatory disease in children and adults. While some infections pose no serious threat to the mother or infant during pregnancy, other severe, untreated bacterial infections can increase the risk of infant infection, miscarriage, or premature delivery.
How does clindamycin work?
Clindamycin works by interfering with bacterial protein development and stops bacterial replication in the body.
If I am taking clindamycin, can it harm my baby?
Clindamycin should only be administered during during pregnancy if clearly indicated. First trimester use of this medication is only recommended if needed and only after weighing the risks versus benefits of taking this medication during pregnancy. There are limited human studies or case reports that have looked at the safety of this medication in pregnancy. Animal studies show that taking clindamycin during pregnancy does not cause harm to your baby. Available studies have found no increased risk of birth defects associated with using clindamycin during pregnancy.
Evidence from animal studies with clindamycin:
When given to pregnant mice and rats at much larger doses than the maximum recommended human dose, clindamycin did not increase the risk of birth defects. One study in a pregnant mouse administered an injection that was 10 times higher than the recommended human dose produced offspring with cleft palate.
Evidence from human studies with clindamycin:
Injections of clindamycin during the second and third trimester have not been associated with an increased risk of birth defects. However, injection solutions containing benzyl alcohol can cause fatal gasping syndrome in premature newborns. A study in over 200,000 women in Michigan between 1985 and 1992 who were exposed to clindamycin (oral, intravenous, injection, and topical) during the first trimester found no increased risk of birth defects. Data from women filling a prescription for clindamycin in Quebec from 1998 to 2008 found an increased risk of birth defects.
Women with a history of preterm delivery and normal vaginal flora who apply clindamycin vaginal cream to prevent preterm delivery may have an increased risk of preterm delivery and neonatal infection. A 2011 study of women with abnormal vaginal flora who applied clindamycin during the second trimester had decreased risk of preterm delivery at less than 37 weeks gestation and decreased risk of late miscarriage. Use of clindamycin during the second trimester in over 200 pregnant women with either asymptomatic abnormal vaginal flora or bacterial vaginosis had decreased later miscarriage and decreased risk of spontaneous preterm delivery. Topical and vaginal applications of clindamycin are not expected to cause negative side effects in infants.
Clindamycin is recommended for many off-label uses in pregnant women including prophylaxis for group B streptococcal disease in newborns, prophylaxis before Cesarean section, malaria treatment, and in women delivering vaginally who are at risk of endocarditis.
Bottom line: Clindamycin should only be used in pregnancy if clearly indicated. First trimester exposure should be avoided unless needed. There have been few human studies that have looked at the safety of clindamycin during pregnancy. Animal studies have shown that clindamycin is not harmful to the developing baby.
If I am taking clindamycin and become pregnant, what should I do?
If you are taking clindamycin and become pregnant, you should contact your doctor immediately. Your doctor will determine if your medication is medically necessary, or if it should be discontinued until after the birth of your baby.
If I am taking clindamycin, can I safely breastfeed my baby?
Breastfeeding while on clindamycin is not recommended by the World Health Organization. However, the American Academy of Pediatrics states breastfeeding should be compatible with clindamycin use. It is important to weigh the risks versus benefits before taking this medication while nursing a newborn. If a mother is on clindamycin while nursing her newborn, the baby should be monitored for negative side effects including diarrhea, thrush, diaper rash, and bloody stool.
Bottom line: In moms who are taking clindamycin, breastfeeding is generally considered safe to continue once the risks versus benefits are considered. Infants exposed to clindamycin through breast milk should be monitored for negative side effects including diarrhea and diaper rash.
If I am taking clindamycin, will it be more difficult to get pregnant?
There have been no studies in men or women that have looked at the effects of clindamycin on fertility. Animal studies have reported that administration of clindamycin doses up to 31 times the recommended human doses did not negatively affect fertility.
If I am taking clindamycin, what should I know?
Clindamycin should only be used during pregnancy if clearly indicated. There have been limited human studies that have looked at the effects of clindamycin in pregnancy.
In moms who are taking clindamycin, breastfeeding may be continued, but nursing infants should be monitored for negative side effects.
If I am taking any medication, what should I know?
This report provides a summary of available information about the use of clindamycin during pregnancy and breastfeeding. Content is from the product label unless otherwise indicated.
You may find Pregistry's expert reports about infections here, and reports about the individual medications used to treat infections here. Additional information can also be found in the resources below.
For more information about clindamycin during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or check the following link:
Merck Manuals: Infections during pregnancy
U.S. Food and Drug Administration: Clindamycin Prescribing Information