Clindamycin used to be a first-line agent for many SSTIs, particularly where MRSA was suspected. With growing resistance to staph species, the 2014 IDSA Guidelines recommend clindamycin as an option only in the following situations:
Nonpurulent SSTI (primarily strep species)
Mild - oral clindamycin
Moderate - IV clindamcyin
Severe, necrotizing infections - adjunctive clindamycin only with suspected or culture-confirmed strep pyogenes
Purulent SSTI (primarily staph species)
Clindamycin only recommended in moderate or severe cases if cultures yield MSSA
* Clindamycin may be used if clindamycin resistance is <10-15% at the institution.
References
Stevens DL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014;59(2):e10-52. [PMID 24947530]
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