Clear Gel is a topical antibiotic containing Clindamycin which is a potent bacteriostatic agent. It is listed in the World Health Organisation’s (WHO) list of essential medicines which include only the safest and most effectual medicines for human use. Clear gel has been found to be effective in alleviating symptoms of various skin conditions.
Clear Gel is an ointment preparation of 1%w/w Clindamycin which is a topically active anti-bacterial agent. Clindamycin is derived semi-synthetically from Lincomycin, which is a natural antibiotic produced by actinobacterium Streptomyces lincolnensis. The ointment which is prepared for topical application is a phosphate ester prodrug of Clindamycin.
Clear gel ointment is used to treat many bacterial skin infections. It is effective against numerous bacteria such as Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pneumoniae.
Clindamycin is also effectual in treating skin and soft tissue infections due to Methicillin-resistant Staphylococcus aureus organisms (MRSA). These are usually resistant to treatment with the conventional first-line therapy with penicillins and hence aggressive second-line treatment with other agents such as clindamycin is usually sought after.
Clear gel with Clindamycin is usually tolerated well with hardly any side-effects. Very rarely in susceptible individuals, the following side-effects may occur:
Rarely allergic or anaphylactic reactions characterised by sudden difficulty to breath, dyspnoea, fever, skin rashes, swelling of face, lips, face, etc may occur. In such cases, the patient should be given immediate emergency care by a certified medical practitioner.
Clindamycin is known to cause a potentially lethal condition called pseudomembranous colitis where there is overgrowth fo Clostridium difficile that is resistant to clindamycin. The bacterium produces an excess of toxins which when released into the gastrointestinal system produce adverse effects such as diarrhoea due to colitis and toxic megacolon. This condition is more commonly encountered with oral intake of Clindamycin and is rarely reported on topical use.
If the patient experiences sudden watery or bloody diarrhoea, then the reporting physician should be consulted immediately for ruling out the possibility of pseudomembrane colitis.
Clear gel topical ointment is for external use on skin only and should not be ingested or applied to mucous membranes. The affected area should be clean and dry before applying a thin layer of the gel. The gel has to be applied once every 12 hours or more as advised by a registered medical practitioner. The dose depends on the duration of symptoms, severity of disease and other factors.
Mechanism of Action of Clear Gel (Clindamycin 1%w/w)
Clear gel’s active ingredient, Clindamycin works by inhibiting protein synthesis in bacterial cells. It is a bacteriostatic similar to macrolides class of drugs and interferes with ribosomal translocation. Clindamycin binds to 50s subunit of ribosomal RNA and interferes with bacterial protein synthesis.
The topical preparation of Clindamycin as Clear Gel is best avoided in the following circumstances:
Clear Gel can be safely used to treat skin infections in Pregnant women.
Though Clindamycin is considered safe for use in Lactating mothers by the American Academy of Paediatrics, the World Health Organisation recommends avoiding the drug if possible during lactation.
Since the macrolide class of antibiotics and clindamycin share similar mechanisms of action, it is better to avoid administering both simultaneously due to the risk of antagonism and cross-resistance.
Clindamycin causes prolongation of the effects of neuromuscular blocking agents such as succinylcholine and vecuronium.
It does not interact with alcohol.
It does not cause renal or hepatic impairment and hence can be used safely in patients with renal or hepatic insufficiency.
Clindamycin interferes with pharmacodynamics of birth control pills which may lose their efficacy if taken along with ClearGel. A secondary birth control measure is generally recommended.
The clear gel may cause or aggravate eczematous skin reactions in susceptible individuals. Hence, patients who are prone to suffer from eczema should exercise caution while planning to use Cleargel for acne or other bacterial skin infections.
Clindac A, Erytop Gel, Zyclin 1% gel, Acnesol 1% gel, D Acne 1% Gel, Mimosee 1% gel, Clenz 1% gel, Clinup 1% gel, Cleocin T, Clindagel, Clindaderm, Clindets, Evoclin.
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