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Updated: Feb 26 2019


  • Snapshot
    • A 33-year-old man presents to his primary care physician for a rash involving his left leg. His symptoms began approximately 7 days ago, when he noted a rash. He is unsure if he had any trauma to the leg but states he has had mild fevers. The patient is allergic to penicillin. His temperature is 100°F (37.7°C), blood pressure is 138/88 mmHg, pulse is 98/min, and respirations are 18/min. Physical examination is notable for an erythematous, edematous, and warm lesion involving the left ankle that is tender to palpation. He is started on clindamycin. (Cellulitis)
  • Introduction
    • Mechanism of action
      • reversibly binds to the 50S ribosomal subunit, impairing bacterial protein synthesis
        • impairs the transpeptidation reaction within the ribosome
    • Clinical use
      • anaerobic infections (e.g., aspiration pneumonia, oral infection, and lung abscess)
        • Bacteroides spp.
        • Clostridium perfringens
        • Fusobacterium spp.
      • staphylococci
      • viridans group streptococci
      • Streptococcus pyogenes
      • Streptococcus pneumoniae
      • group A streptococcal infection
    • Adverse effects
      • Clostridium difficile infection (pseudomembranous colitis)
      • fever
      • diarrhea
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