Effects of topical clindamycin on intestinal microflora in patients with acne

J Am Acad Dermatol. 1986 Aug;15(2 Pt 1):180-5. doi: 10.1016/s0190-9622(86)70153-9.


Thirty-two patients with acne completed a randomized, double-blind study using topical 1% clindamycin phosphate or its vehicle applied twice daily for 8 weeks for a study of its effects on the intestinal microflora. Two clindamycin patients and one vehicle patient had Clostridium difficile in stools prior to therapy. Of the remaining twenty-nine patients, four of nineteen patients who used clindamycin and none of ten patients who used vehicle had C. difficile detected during treatment; the difference was not statistically significant. There was no diarrhea in the clindamycin group, even though clostridial cytotoxin was found transiently in two patients. Self-limited diarrhea occurred in one vehicle-treated patient, whose stool culture was negative but whose stool specimen showed a positive reaction for C. difficile cytotoxin. With the use of a bioassay, clindamycin was not detected in urine or stool of any patient. No significant changes in Bacteroides fragilis counts in stools were observed in either group.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / microbiology
  • Administration, Topical
  • Adolescent
  • Adult
  • Bacterial Proteins*
  • Bacterial Toxins / analysis
  • Bacteroides fragilis / drug effects
  • Clindamycin / administration & dosage
  • Clindamycin / metabolism
  • Clindamycin / pharmacology*
  • Clostridium / drug effects*
  • Feces / microbiology
  • Humans
  • Intestinal Absorption
  • Intestines / microbiology*


  • Bacterial Proteins
  • Bacterial Toxins
  • toxB protein, Clostridium difficile
  • Clindamycin