Clindamycin, marketed as Dalacin in its topical form (Dalacin T), is a lincosamide antibiotic available in both systemic (oral capsules: 75 mg, 150 mg; IV/IM injection) and topical preparations (1% solution and gel for acne; 2% vaginal cream for bacterial vaginosis). It is active against a wide range of Gram-positive bacteria and anaerobes, including organisms resistant to other antibiotic classes.

Dalacin T (clindamycin 1% topical solution or gel) is specifically indicated for the topical treatment of acne vulgaris. Oral and parenteral clindamycin (also sold as Dalacin C) is reserved for the treatment of serious infections caused by sensitive organisms, particularly where penicillins or other first-line antibiotics are unsuitable.

Clindamycin preparations are prescription-only in the UK. A licensed clinician must assess the indication, likely organisms, and the potential for serious adverse effects — particularly Clostridium difficile colitis — before prescribing.

Acne vulgaris (topical: Dalacin T) — inflammatory and mixed-pattern acne; used in combination with a retinoid or benzoyl peroxide to prevent resistance.

Clindamycin exerts its antibacterial effect by binding to the 50S ribosomal subunit of susceptible bacteria — specifically the 23S rRNA component — and inhibiting peptide bond formation during protein synthesis. This disrupts bacterial translation and prevents bacterial growth (bacteriostatic effect). At higher concentrations and against susceptible organisms, clindamycin can be bactericidal.

Spectrum of activity:

• Gram-positive aerobes — Staphylococcus aureus (including many MSSA strains), Streptococcus pyogenes, Streptococcus pneumoniae
• Anaerobes — Bacteroides fragilis, Clostridium perfringens, Fusobacterium species, and peptococci — making it particularly valuable in intra-abdominal, pelvic, and aspiration infections
• Cutibacterium acnes (topical use) — the key pathogen in inflammatory acne vulgaris

Importantly, clindamycin has no activity against Gram-negative aerobic organisms (such as Enterobacteriaceae or Pseudomonas), making it unsuitable as monotherapy for polymicrobial infections unless combined with Gram-negative coverage.

The correct dose depends on the type and severity of infection, age, weight, and kidney function. Always follow your clinician's instructions. The table below is for general reference only.

For Dalacin T (topical): Apply a thin layer to the entire acne-affected area (not just individual spots), not solely to active lesions. Allow to dry before applying other products. Always combine with a retinoid or benzoyl peroxide to reduce resistance risk.

For vaginal cream: Use the supplied applicator to insert the cream high into the vagina at bedtime. Avoid sexual intercourse during the treatment course. Note that the cream may weaken latex condoms and diaphragms.

For oral capsules: Take with a full glass of water and remain upright for at least 30 minutes after ingestion to reduce the risk of oesophageal irritation. Can be taken with food to reduce GI discomfort.

Complete the full course of oral antibiotics to ensure eradication and prevent resistance.

Most side effects are mild and resolve on their own. Serious side effects are rare but require immediate medical attention.

Always disclose all prescription drugs, over-the-counter medicines, vitamins, and supplements to your clinician or pharmacist before starting clindamycin

Getting advice no longer means sitting in a waiting room. Through The GP Service, you can consult with a licensed clinician in minutes — from home, on your lunch break, or wherever works for you. If treatment is clinically appropriate, your clinician can issue a prescription during the consultation. A consultation does not guarantee a prescription.