Clindamycin - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

CLINDAMYCIN A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1 Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Clindamycin: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84376-7 1. Clindamycin-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on clindamycin. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON CLINDAMYCIN .......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Clindamycin.................................................................................. 4 E-Journals: PubMed Central ......................................................................................................... 6 The National Library of Medicine: PubMed ................................................................................ 19 CHAPTER 2. NUTRITION AND CLINDAMYCIN ................................................................................ 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Clindamycin ................................................................................ 61 Federal Resources on Nutrition ................................................................................................... 65 Additional Web Resources ........................................................................................................... 65 CHAPTER 3. ALTERNATIVE MEDICINE AND CLINDAMYCIN .......................................................... 67 Overview...................................................................................................................................... 67 National Center for Complementary and Alternative Medicine.................................................. 67 Additional Web Resources ........................................................................................................... 71 General References ....................................................................................................................... 72 CHAPTER 4. CLINICAL TRIALS AND CLINDAMYCIN....................................................................... 73 Overview...................................................................................................................................... 73 Recent Trials on Clindamycin ..................................................................................................... 73 Keeping Current on Clinical Trials ............................................................................................. 75 CHAPTER 5. PATENTS ON CLINDAMYCIN ....................................................................................... 77 Overview...................................................................................................................................... 77 Patents on Clindamycin............................................................................................................... 77 Patent Applications on Clindamycin........................................................................................... 89 Keeping Current .......................................................................................................................... 92 CHAPTER 6. BOOKS ON CLINDAMYCIN .......................................................................................... 93 Overview...................................................................................................................................... 93 Book Summaries: Federal Agencies.............................................................................................. 93 Book Summaries: Online Booksellers........................................................................................... 94 Chapters on Clindamycin ............................................................................................................ 94 CHAPTER 7. PERIODICALS AND NEWS ON CLINDAMYCIN............................................................. 99 Overview...................................................................................................................................... 99 News Services and Press Releases................................................................................................ 99 Newsletter Articles .................................................................................................................... 101 Academic Periodicals covering Clindamycin............................................................................. 102 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 103 Overview.................................................................................................................................... 103 U.S. Pharmacopeia..................................................................................................................... 103 Commercial Databases ............................................................................................................... 104 Researching Orphan Drugs ....................................................................................................... 104 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 109 Overview.................................................................................................................................... 109 NIH Guidelines.......................................................................................................................... 109 NIH Databases........................................................................................................................... 111 Other Commercial Databases..................................................................................................... 113 APPENDIX B. PATIENT RESOURCES ............................................................................................... 115 Overview.................................................................................................................................... 115 Patient Guideline Sources.......................................................................................................... 115 Finding Associations.................................................................................................................. 118 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 121

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Overview.................................................................................................................................... 121 Preparation................................................................................................................................. 121 Finding a Local Medical Library................................................................................................ 121 Medical Libraries in the U.S. and Canada ................................................................................. 121 ONLINE GLOSSARIES................................................................................................................ 127 Online Dictionary Directories ................................................................................................... 127 CLINDAMYCIN DICTIONARY ................................................................................................ 129 INDEX .............................................................................................................................................. 177

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with clindamycin is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about clindamycin, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to clindamycin, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on clindamycin. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to clindamycin, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on clindamycin. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON CLINDAMYCIN Overview In this chapter, we will show you how to locate peer-reviewed references and studies on clindamycin.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and clindamycin, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “clindamycin” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Hospital-wide Restriction of Clindamycin: Effect on the Incidence of Clostridium difficile-Associated Diarrhea and Cost Source: Annals of Internal Medicine. 128(12 Pt 1): 989-995. June 15, 1998. Summary: Widespread use of antibiotics has been associated with increases in bacterial resistance and nosocomial infection. This article reports on a prospective, observational cohort study undertaken to characterize the impact of hospital-wide clindamycin restriction on the incidence of Clostridium difficile-associated diarrhea and on antimicrobial prescribing practices. Clinical data on individual hospitalized patients with symptomatic diarrhea and data on antibiotic use were obtained from hospital pharmacy records. Hospital-wide use of antimicrobial agents was monitored. Isolates of C. difficile underwent antimicrobial susceptibility testing and molecular typing. Results showed that an outbreak of C. difficile-associated diarrhea was caused by a clonal

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isolate of clindamycin-resistant C. difficile and was related to increased use of clindamycin. A hospital-wide requirement that clindamycin be approved by an infectious disease consultant led to an overall reduction in use, a sustained reduction in the mean number of cases of C. difficile-associated diarrhea, and an increase in clindamycin susceptibility among C. difficile isolates. A parallel increase was noted in the use of and costs associated with other antibiotics with antianaerobic activity. The hospital realized overall cost savings as a result of the decreased incidence of C. difficile associated diarrhea. The authors conclude that hospital formulary restriction of clindamycin is an effective way to decrease the number of C. difficile infections. 3 figures. 1 table. 27 references. (AA-M).

Federally Funded Research on Clindamycin The U.S. Government supports a variety of research studies relating to clindamycin. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to clindamycin. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore clindamycin. The following is typical of the type of information found when searching the CRISP database for clindamycin: •

Project Title: CHEMISTRY AND IMMUNOLOGY OF STREPTOCOCCAL M PROTEINS Principal Investigator & Institution: Dale, James B.; Professor; Medicine; University of Tennessee Health Sci Ctr Memphis, Tn 38163 Timing: Fiscal Year 2003; Project Start 01-JUN-1996; Project End 31-MAY-2006 Summary: (provided by applicant): The overall goal of this project is to systematically collect group A streptococci (GrAS) from throats of North American children with acute streptococcal pharyngitis from diverse geographic primary care locations for characterization of isolates. We have recently completed a phase I clinical trial of a 26valent group A streptococcal M protein-based vaccine. The efficacy of the vaccine will depend, among other things, on the epidemiology of group A streptococcal infections, including the prevalence of M types in open populations over extended periods of time and the allelic variations that occur in emm genes within a serotype. The specific aims of this supplemental funding request are 1) To determine the distribution of emm types and allelic variation of GrAS isolates from throat cultures of children 3-18 years old from 13 geographic sites in North America with symptomatic acute streptococcal pharyngitis, and to assess the inter-site and the year-to-year variations in emm type distribution, and

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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2) To use selected clinical isolates to determine the potential protective efficacy of the 26valent vaccine that is currently in clinical trials. Building upon the surveillance system utilized during the past two respiratory seasons (2000-2001 and 2001-2002), we propose to expand the number of primary care pediatric sites to 13 for the next 3 respiratory seasons, with each site providing a total of 100 GrAS isolates collected from children 318 years old during four scheduled periods per season. Specimens (cultures and swabs) will be shipped to Dr. Shulman's Infectious Diseases Laboratory in Chicago, isolated and confirmed as GrAS. DNA will be extracted from overnight growths, stored, catalogued, frozen and then shipped to the Streptococcal Molecular Epidemiology Laboratory of the Centers for Disease Control and Prevention (CDC) for emm gene sequencing, including determination of alleles based upon 650-750 base partial sequences. Frequencies of individual emm types nationally and at each site will be calculated, with inter-site and inter-seasonal assessments made. In addition, all strains will also be assessed for macrolide, clindamycin, and ketolide resistance by microbroth tube dilution studies in the Infectious Diseases Laboratory in Chicago, and correlations will be made between emm type and macrolide resistance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GENTAMICIN/CLINDAMYCIN IN PREVENTION OF POSTPARTUM ENDOMYOMETRITIS Principal Investigator & Institution: Ross, Michael G.; Professor and Chair; Harbor-Ucla Research & Educ Inst 1124 W Carson St Torrance, Ca 90502 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ROLE OF BRRA-BRRB IN ANTHRAX Principal Investigator & Institution: Schlievert, Patrick M.; Professor; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2003; Project Start 04-SEP-2003; Project End 31-AUG-2005 Summary: The long-term goals are to understand human pathogenesis of Bacillus anthracis, which has potential for use in bioterrorism. Our studies are also directed towards identifying methods to prevent production of virulence factors by this organism to cause disease. We have shown bacterial surface-active agents, glycerol monolaurate and chitosan malate, preventing production of the superantigens when produced in B. subtilis. In addition, we have suggested (with success) that patients with inhalation anthrax be treated with clindamycin in addition to other therapy because of the antibiotic's known ability to inhibit gram positive exotoxin production at subbacterial inhibitory levels. We have shown that Staphylococcus aureus requires oxygen and carbon dioxide in its external environment for maximal production of TSST-1. This observation led to our identification of a two-component regulatory system that is involved in oxygen control of superantigen production by the organism. We have shown that over-expression of this system, designated srrA/B (for staphylococcal respiratory response), in S. aureus significantly represses superantigen production. By computer analysis we identified a Bacillus anthracis homolog of SrrA-SrrB, tentatively designated BrrA-BrrB, and hypothesize that this two-component regulatory system is important in controlling anthrax toxin and capsule production. Furthermore, we hypothesize that BrrA-BrrB is an important target for the action of glycerol monolaurate and chitosan malate. In this application we propose one specific aim: 1) to characterize

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BrrA-BrrB and its effect on production of B. anthracis toxin and capsule. We hypothesize that this system functions as a repressor of genes for both virulence factors. Overexpression of the system will interfere with production of exotoxin and capsule by the organism, even under highly aerobic conditions. Finally, we hypothesize that exotoxin and capsule production will be suppressed by both glycerol monolaurate and chitosan malate through activation of BrrA-BrrB. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THERAPY AND PREVENTION FOR BACTERIAL VAGINOSIS Principal Investigator & Institution: Schwebke, Jane R.; Professor; Medicine; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-JAN-2002; Project End 31-DEC-2007 Summary: Bacterial vaginosis (BV) is a sexually associated disease caused by a complex mixture or anaerobic bacteria. BV is the most prevalent cause of symptomatic vaginal discharge in the U.S. and is associated with numerous complications including pre term delivery of infants, pelvic inflammatory disease, urinary tract infections and acquisition/transmission of sexually transmitted diseases including human immunodeficiency virus. Widespread control of BV has been suggested as a possible means for decreasing the incidence of HIV in the developing world, however, current achievable cure rates combined with high recurrence rates makes this solution impractical. Further, half of all women who meet the clinical diagnostic criteria for BV are asymptomatic and the appropriate management of these women is unknown. Although the microbiological changes which occur in women with symptomatic and asymptomatic BV appear by culture techniques to be identical, the clinical significance of asymptomatic BV is unclear. The current therapy for BV consists of seven days of oral or topical metronidazole or clindamycin. However, there is a growing concern that eradication of organisms from the lower genital tract may be inadequate to prevent recurrences or complications and that more intensive therapy may be required for eradication of upper tract infection/colonization. Further, some of the key organisms associated with BV such as Mobiluncus and mycoplasmas are resistant to the standard therapies. Lastly, although BV has epidemiological characteristics of an STD, the role of the male partner in its pathogenesis remains unknown. We propose to conduct clinical trials which will assess enhanced therapy for BV, including longer duration of therapy and combination therapy as well as increased use of condoms to improve initial cure rates and decrease recurrences. We will also utilize specimens from these prospective studies to further study the association of Mobiluncus, an organism strongly associated with BV using sensitive PCR technology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age.

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unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “clindamycin” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for clindamycin in the PubMed Central database: •

Activities of a New Fluoroketolide, HMR 3787, and Its (Des)-Fluor Derivative RU 64399 Compared to Those of Telithromycin, Erythromycin A, Azithromycin, Clarithromycin, and Clindamycin against Macrolide-Susceptible or -Resistant Streptococcus pneumoniae and S. pyogenes. by Nagai K, Davies TA, Ednie LM, Bryskier A, Palavecino E, Jacobs MR, Appelbaum PC.; 2001 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90817

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Activity of clindamycin with primaquine against Pneumocystis carinii in vitro and in vivo. by Queener SF, Bartlett MS, Richardson JD, Durkin MM, Jay MA, Smith JW.; 1988 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172287

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Activity of fleroxacin alone and in combination with clindamycin or metronidazole in experimental intra-abdominal abscesses. by Pefanis A, Thauvin-Eliopoulos C, Holden J, Eliopoulos GM, Ferraro MJ, Moellering RC Jr.; 1994 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284436

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Activity of WY-49605 compared with those of amoxicillin, amoxicillin-clavulanate, imipenem, ciprofloxacin, cefaclor, cefpodoxime, cefuroxime, clindamycin, and metronidazole against 384 anaerobic bacteria. by Spangler SK, Jacobs MR, Appelbaum PC.; 1994 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188248

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An Enterococcus faecalis ABC Homologue (Lsa) Is Required for the Resistance of This Species to Clindamycin and Quinupristin-Dalfopristin. by Singh KV, Weinstock GM, Murray BE.; 2002 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127256

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Antianaerobic activity of the ketolide RU 64004 compared to activities of four macrolides, five beta-lactams, clindamycin, and metronidazole. by Ednie LM, Spangler SK, Jacobs MR, Appelbaum PC.; 1997 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163846

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Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam-ampicillin versus clindamycin-amikacin. by Phan M, Van der Auwera P, Andry G, Aoun M, Chantrain G, Deraemaecker R, Dor P, Daneau D, Ewalenko P, Meunier F.; 1992 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192428

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Antipneumococcal Activities of a Ketolide (HMR 3647), a Streptogramin (Quinupristin-Dalfopristin), a Macrolide (Erythromycin), and a Lincosamide (Clindamycin). by Barry AL, Fuchs PC, Brown SD.; 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105575

5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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Bactericidal activity of DU-6859a compared to activities of three quinolones, three beta-lactams, clindamycin, and metronidazole against anaerobes as determined by time-kill methodology. by Spangler SK, Jacobs MR, Appelbaum PC.; 1997 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163808

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Bactericidal activity of low-dose clindamycin administered at 8- and 12-hour intervals against Staphylococcus aureus, Streptococcus pneumoniae, and Bacteroides fragilis. by Klepser ME, Nicolau DP, Quintiliani R, Nightingale CH.; 1997 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163763

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Bactericidal Activity of Quinupristin-Dalfopristin against Staphylococcus aureus: Clindamycin Susceptibility as a Surrogate Indicator. by Fuchs PC, Barry AL, Brown SD.; 2000 Oct; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90170

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Bacteroides fragilis resistance to clindamycin in vitro. by Sosa A, Tally FP, Jacobus NV, Gorbach SL.; 1982 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185658

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Cefonicid versus clindamycin prophylaxis for head and neck surgery in a randomized, double-blind trial, with pharmacokinetic implications. by Swanson D, Maxwell RA, Johnson JT, Wagner RL, Yu VL.; 1991 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245172

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Cefoperazone versus clindamycin plus gentamicin for obstetric and gynecologic infections. by Gilstrap LC 3rd, St Clair PJ, Gibbs RS, Maier RC.; 1986 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=176542

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Characterization and mapping of regions encoding clindamycin resistance, tetracycline resistance, and a replication function on the Bacteroides R plasmid pCP1. by Matthews BG, Guiney DG.; 1986 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=212919

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Characterization of bactericidal activity of clindamycin against Bacteroides fragilis via kill curve methods. by Klepser ME, Banevicius MA, Quintiliani R, Nightingale CH.; 1996 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163446

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Characterization of Bacteroides ovatus plasmid pBI136 and structure of its clindamycin resistance region. by Smith CJ.; 1985 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=215008

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Characterization of pBFTM10, a clindamycin-erythromycin resistance transfer factor from Bacteroides fragilis. by Tally FP, Snydman DR, Shimell MJ, Malamy MH.; 1982 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=220309

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Clindamycin as an Antimalarial Drug: Review of Clinical Trials. by Lell B, Kremsner PG.; 2002 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127356

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Clindamycin enhances opsonization of Staphylococcus aureus. by Milatovic D, Braveny I, Verhoef J.; 1983 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185334

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Clindamycin in a murine model of toxoplasmic encephalitis. by Hofflin JM, Remington JS.; 1987 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174765

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Clindamycin Modulates Inflammatory-Cytokine Induction in LipopolysaccharideStimulated Mouse Peritoneal Macrophages. by Nakano T, Hiramatsu K, Kishi K, Hirata N, Kadota JI, Nasu M.; 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=148975

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Clindamycin Suppresses Endotoxin Released by Ceftazidime-Treated Escherichia coli O55:B5 and Subsequent Production of Tumor Necrosis Factor Alpha and Interleukin1[beta]. by Kishi K, Hirai K, Hiramatsu K, Yamasaki T, Nasu M.; 1999 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89169

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Clindamycin therapy of experimental meningitis caused by penicillin- and cephalosporin-resistant Streptococcus pneumoniae. by Paris MM, Shelton S, Trujillo M, Hickey SM, McCracken GH Jr.; 1996 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163069

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Clindamycin therapy of experimental Staphylococcus aureus endocarditis. by Scheld WM, Johnson ML, Gerhardt EB, Sande MA.; 1982 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181958

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Clindamycin, erythromycin, and roxithromycin inhibit the proinflammatory interactions of Pseudomonas aeruginosa pigments with human neutrophils in vitro. by Ras GJ, Anderson R, Taylor GW, Savage JE, van Niekerk E, Joone G, Koornhof HJ, Saunders J, Wilson R, Cole PJ.; 1992 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=190324

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Clinical resistance to erythromycin and clindamycin in cutaneous propionibacteria isolated from acne patients is associated with mutations in 23S rRNA. by Ross JI, Eady EA, Cove JH, Jones CE, Ratyal AH, Miller YW, Vyakrnam S, Cunliffe WJ.; 1997 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163871

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Comparative evaluation of cefazolin and clindamycin in the treatment of experimental Staphylococcus aureus osteomyelitis in rabbits. by Mader JT, Adams K, Morrison L.; 1989 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172751

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Clindamycin

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Comparative penetration of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam into bone. by Summersgill JT, Schupp LG, Raff MJ.; 1982 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181949

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Comparative pharmacokinetics and serum inhibitory activity of clindamycin in different dosing regimens. by Flaherty JF, Rodondi LC, Guglielmo BJ, Fleishaker JC, Townsend RJ, Gambertoglio JG.; 1988 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=176026

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Comparative study of bioavailabilities and pharmacokinetics of clindamycin in healthy volunteers and patients with AIDS. by Gatti G, Flaherty J, Bubp J, White J, Borin M, Gambertoglio J.; 1993 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187917

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Comparison of mutants of Toxoplasma gondii selected for resistance to azithromycin, spiramycin, or clindamycin. by Pfefferkorn ER, Borotz SE.; 1994 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284392

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Controlled Trial of 3-Day Quinine-Clindamycin Treatment versus 7-Day Quinine Treatment for Adult Travelers with Uncomplicated Falciparum Malaria Imported from the Tropics. by Parola P, Ranque S, Badiaga S, Niang M, Blin O, Charbit JJ, Delmont J, Brouqui P.; 2001 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90396

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Development and use of cloning systems for Bacteroides fragilis: cloning of a plasmid-encoded clindamycin resistance determinant. by Smith CJ.; 1985 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=214243

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Development of interpretive criteria and quality control limits for macrolide and clindamycin susceptibility testing of Streptococcus pneumoniae. by Jorgensen JH, Swenson JM, Tenover FC, Barry A, Ferraro MJ, Murray PR, Reller LB.; 1996 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=229385

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Diversity of Ribosomal Mutations Conferring Resistance to Macrolides, Clindamycin, Streptogramin, and Telithromycin in Streptococcus pneumoniae. by Canu A, Malbruny B, Coquemont M, Davies TA, Appelbaum PC, Leclercq R.; 2002 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=126998

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Effect of clindamycin on intracellular replication, protein synthesis, and infectivity of Toxoplasma gondii. by Blais J, Tardif C, Chamberland S.; 1993 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=192741

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Effect of clindamycin on neutrophil killing of gram-negative periodontal bacteria. by Baker PJ, Wilson ME.; 1988 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=175911

Studies

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Effect of clindamycin on pneumonia from reactivation of Toxoplasma gondii infection in mice. by Filice GA, Pomeroy C.; 1991 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245100

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Effect of clindamycin prophylaxis on the colonic microflora in patients undergoing colorectal surgery. by Kager L, Liljeqvist L, Malmborg AS, Nord CE.; 1981 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181792

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Effect of clindamycin, erythromycin, lincomycin, and tetracycline on growth and extracellular lipase production by propionibacteria in vitro. by Unkles SE, Gemmell CG.; 1982 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181825

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Effects of clindamycin and metronidazole on the intestinal colonization and translocation of enterococci in mice. by Wells CL, Jechorek RP, Maddaus MA, Simmons RL.; 1988 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=176015

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Effects of subminimal inhibitory concentrations of Erythromycin, Clindamycin, and Pristinamycin on the penicillinase production of Staphlyococcus aureus. by Michel J, Stessman P, Stessman J.; 1980 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=283718

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Efficacies of ofloxacin, rifampin, and clindamycin in treatment of Staphylococcus aureus abscesses and correlation with results of an in vitro assay of intracellular bacterial killing. by Bamberger DM, Herndon BL, Dew M, Chern RP, Mitchell H, Summers LE, Marcus RF, Kim SC, Suvarna PR.; 1997 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163877

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Efficacy and safety of aztreonam-clindamycin versus tobramycin-clindamycin in the treatment of lower respiratory tract infections caused by aerobic gram-negative bacilli. by Rodriguez JR, Ramirez-Ronda CH, Nevarez M.; 1985 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=176247

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Efficacy of clarithromycin versus that of clindamycin for single-dose prophylaxis of experimental streptococcal endocarditis. by Vermot D, Entenza JM, Vouillamoz J, Glauser MP, Moreillon P.; 1996 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163207

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Emergence of Erythromycin-Resistant, Clindamycin-Susceptible Streptococcus pyogenes Isolates in Madrid, Spain. by Garcia-Bermejo I, Cacho J.; 1998 Apr; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105590

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Erythromycin and Clindamycin Resistance and Telithromycin Susceptibility in Streptococcus agalactiae. by Betriu C, Culebras E, Gomez M, Rodriguez-Avial I, Sanchez BA, Agreda MC, Picazo JJ.; 2003 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149330

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Clindamycin

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Evaluation of Low-Dose, Extended-Interval Clindamycin Regimens against Staphylococcus aureus and Streptococcus pneumoniae Using a Dynamic In Vitro Model of Infection. by Lewis RE, Klepser ME, Ernst EJ, Lund BC, Biedenbach DJ, Jones RN.; 1999 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89405

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Evaluation of the 10-micrograms clindamycin disk for susceptibility testing of anaerobes by the aerobically incubated thioglycolate broth disk method. by Toohey KL, Kurzynski TA, Schell RF, Birk RJ, Zabransky RJ.; 1986 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=268706

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Evidence that the clindamycin-erythromycin resistance gene of Bacteroides plasmid pBF4 is on a transposable element. by Shoemaker NB, Guthrie EP, Salyers AA, Gardner JF.; 1985 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=218895

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Genetic characterization of a Clostridium difficile erythromycin-clindamycin resistance determinant that is transferable to Staphylococcus aureus. by Hachler H, Berger-Bachi B, Kayser FH.; 1987 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174868

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Gingival crevicular fluid levels of clindamycin compared with its minimal inhibitory concentrations for periodontal bacteria. by Walker CB, Gordon JM, Cornwall HA, Murphy JC, Socransky SS.; 1981 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181536

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Guinea pig model for antibiotic transport across gastric mucosa: inhibitory tissue concentrations of clindamycin against Helicobacter pylori (Campylobacter pylori) following two separate dose regimens. by Westblom TU, Duriex DE, Madan E, Belshe RB.; 1990 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171514

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High Incidence of Cefoxitin and Clindamycin Resistance among Anaerobes in Taiwan. by Teng LJ, Hsueh PR, Tsai JC, Liaw SJ, Ho SW, Luh KT.; 2002 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127412

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Hybridization studies reveal homologies between pBF4 and pBFTM10, Two clindamycin-erythromycin resistance transfer plasmids of Bacteroides fragilis. by Shimell MJ, Smith CJ, Tally FP, Macrina FL, Malamy MH.; 1982 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=221560

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In vitro activities of azithromycin (CP 62,993), clarithromycin (A-56268; TE-031), erythromycin, roxithromycin, and clindamycin. by Barry AL, Jones RN, Thornsberry C.; 1988 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172265

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In Vitro Activities of Ketolide HMR 3647, Macrolides, and Clindamycin against Coryneform Bacteria. by Martinez-Martinez L, Pascual A, Suarez AI, Perea EJ.; 1998 Dec; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=106038

Studies

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In vitro activity of a new macrolide, A-56268, compared with that of roxithromycin, erythromycin, and clindamycin. by Barry AL, Thornsberry C, Jones RN.; 1987 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174723

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In vitro activity of A-56268 (TE-031), a new macrolide, compared with that of erythromycin and clindamycin against selected gram-positive and gram-negative organisms. by Benson CA, Segreti J, Beaudette FE, Hines DW, Goodman LJ, Kaplan RL, Trenholme GM.; 1987 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174717

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In vitro activity of pipecolic acid amide of clindamycin (U-57930E) on anaerobic bacteria compared with those of clindamycin, cefoxitin, and chloramphenicol. by Dhawan VK, Bansal MB, Thadepalli H.; 1982 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=183741

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In vitro activity of U-57930E, a new clindamycin analog, against aerobic gram-positive bacteria. by Ahonkhai VI, Cherubin CE, Shulman MA, Jhagroo M, Bancroft U.; 1982 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=182043

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In vitro and in vivo effects of penicillin and clindamycin on expression of group A beta-hemolytic streptococcal capsule. by Brook I, Gober AE, Leyva F.; 1995 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162782

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In Vitro and In Vivo Synergy of Fosmidomycin, a Novel Antimalarial Drug, with Clindamycin. by Wiesner J, Henschker D, Hutchinson DB, Beck E, Jomaa H.; 2002 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=127394

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In vitro antibacterial activity of the combination of clindamycin and ceftazidime. by George WL.; 1984 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185610

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In Vitro Antimicrobial Effects of Various Combinations of Penicillin and Clindamycin against Four Strains of Streptococcus pyogenes. by Stevens DL, MadarasKelly KJ, Richards DM.; 1998 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105799

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In vitro assays elucidate peculiar kinetics of clindamycin action against Toxoplasma gondii. by Fichera ME, Bhopale MK, Roos DS.; 1995 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162776

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In vitro comparison of clindamycin and pirlimycin (U-57930E) activity against Staphylococcus aureus. by Evans ME, Patterson LS, Stratton CW.; 1982 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=183736

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In Vitro Development of Resistance to Telithromycin (HMR 3647), Four Macrolides, Clindamycin, and Pristinamycin in Streptococcus pneumoniae. by Davies TA, Dewasse BE, Jacobs MR, Appelbaum PC.; 2000 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89694

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Clindamycin

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In vitro evaluation of CP-62,993, erythromycin, clindamycin, and tetracycline against Chlamydia trachomatis. by Walsh M, Kappus EW, Quinn TC.; 1987 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174839

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In vitro interaction between rifampin and clindamycin against pathogenic coagulasenegative staphylococci. by Arditi M, Yogev R.; 1989 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171467

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In vitro susceptibilities of ocular Bacillus cereus isolates to clindamycin, gentamicin, and vancomycin alone or in combination. by Gigantelli JW, Torres Gomez J, Osato MS.; 1991 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=244970

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In vitro synergy of clindamycin and aminoglycosides against Chlamydia trachomatis. by Pearlman MD, Faro S, Riddle GD, Tortolero G.; 1990 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=175989

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In vivo efficacies of quinolones and clindamycin for treatment of infections with Bacteroides fragilis and/or Escherichia coli in mice: correlation with in vitro susceptibilities. by Brook I.; 1993 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=187875

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Inducible expression of ribosomal clindamycin resistance in Bacteroides vulgatus. by Reig M, Fernandez MC, Ballesta JP, Baquero F.; 1992 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=190570

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Influence of clindamycin on derepression of beta-lactamases in Enterobacter spp. and Pseudomonas aeruginosa. by Sanders CC, Sanders WE Jr, Goering RV.; 1983 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185103

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Influence of subinhibitory concentrations of clindamycin on opsonophagocytosis of Staphylococcus aureus, a protein-A-dependent process. by Veringa EM, Verhoef J.; 1986 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=176538

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Influence of subinhibitory concentrations of penicillin, cephalothin, and clindamycin on Staphylococcus aureus growth in human phagocytic cells. by Elliott GR, Peterson PK, Verbrugh HA, Freiberg MR, Hoidal JR, Quie PG.; 1982 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185660

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Influences of Linezolid, Penicillin, and Clindamycin, Alone and in Combination, on Streptococcal Pyrogenic Exotoxin A Release. by Coyle EA, Cha R, Rybak MJ.; 2003 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153301

Studies

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Interaction of the antibiotics clindamycin and lincomycin with Escherichia coli 23S ribosomal RNA. by Douthwaite S.; 1992 Sep 25; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=334222

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Interactions of ciprofloxacin with clindamycin, metronidazole, cefoxitin, cefotaxime, and mezlocillin against gram-positive and gram-negative anaerobic bacteria. by Whiting JL, Cheng N, Chow AW.; 1987 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=174946

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Large transmissible clindamycin resistance plasmid in Bacteroides ovatus. by Smith CJ, Macrina FL.; 1984 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=215494

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Membrane transport of clindamycin in alveolar macrophages. by Hand WL, KingThompson NL.; 1982 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181866

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Microbial Transformation of Antibiotics: Phosphorylation of Clindamycin by Streptomyces coelicolor Muller. by Coats JH, Argoudelis AD.; 1971 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=247086

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Modified broth-disk surveillance of clindamycin-resistant Bacteroides fragilis group. by Zar FA.; 1983 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185017

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Molecular survey of clindamycin and tetracycline resistance determinants in Bacteroides species. by Fletcher HM, Macrina FL.; 1991 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245395

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New micromethod to study the effect of antimicrobial agents on Toxoplasma gondii: comparison of sulfadoxine and sulfadiazine individually and in combination with pyrimethamine and study of clindamycin, metronidazole, and cyclosporin A. by Mack DG, McLeod R.; 1984 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=179910

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Occurrence of clindamycin-resistant anaerobic bacteria isolated from cultures taken following clindamycin therapy. by Ohm-Smith MJ, Sweet RL, Hadley WK.; 1986 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=176425

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Paradoxical effect of clindamycin in experimental, acute toxoplasmosis in cats. by Davidson MG, Lappin MR, Rottman JR, Tompkins MB, English RV, Bruce AT, Jayawickrama J.; 1996 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163330

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Clindamycin

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Parasiticidal effect of clindamycin on Toxoplasma gondii grown in cultured cells and selection of a drug-resistant mutant. by Pfefferkorn ER, Nothnagel RF, Borotz SE.; 1992 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188841

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Penetration of Clindamycin and Its Metabolite N-Demethylclindamycin into Cerebrospinal Fluid following Intravenous Infusion of Clindamycin Phosphate in Patients with AIDS. by Gatti G, Malena M, Casazza R, Borin M, Bassetti M, Cruciani M.; 1998 Nov; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=105985

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Penetration of clindamycin, cefoxitin, and metronidazole into pelvic peritoneal fluid of women undergoing diagnostic laparoscopy. by Berger SA, Kupferminc M, Lessing JB, Gorea A, Gull I, Peyser MR.; 1990 Feb; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=171594

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Pharmacokinetic evaluation of two dosage regimens of clindamycin phosphate. by Plaisance KI, Drusano GL, Forrest A, Townsend RJ, Standiford HC.; 1989 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172501

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Pharmacokinetics and serum bactericidal activities of quinolones in combination with clindamycin, metronidazole, and ornidazole. by Boeckh M, Lode H, Deppermann KM, Grineisen S, Shokry F, Held R, Wernicke K, Koeppe P, Wagner J, Krasemann C, et al.; 1990 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172070

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Possible interaction between clindamycin and cyclosporin. by Thurnheer R, Laube I, Speich R.; 1999 Jul 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=59109

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Pretreatment of Mice with Clindamycin Improves Survival of Endotoxic Shock by Modulating the Release of Inflammatory Cytokines. by Hirata N, Hiramatsu K, Kishi K, Yamasaki T, Ichimiya T, Nasu M.; 2001 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90706

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Prevention of clindamycin-induced mortality in hamsters by Saccharomyces boulardii. by Toothaker RD, Elmer GW.; 1984 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=179962

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Prospective cost analysis of moxalactam versus clindamycin plus gentamicin for endomyometritis after cesarean section. by Knodel LC, Goldspiel BR, Gibbs RS.; 1988 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=172295

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Protein binding of clindamycin in sera of patients with AIDS. by Flaherty JF Jr, Gatti G, White J, Bubp J, Borin M, Gambertoglio JG.; 1996 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163278

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Quinine plus clindamycin improves chemotherapy of severe malaria in children. by Kremsner PG, Radloff P, Metzger W, Wildling E, Mordmuller B, Philipps J, Jenne L, Nkeyi M, Prada J, Bienzle U.; 1995 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=162790

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Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. by Blanco JD, Gibbs RS, Duff P, Castaneda YS, St Clair PJ.; 1983 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185362

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Rapid detection of clindamycin resistance in Bacteroides spp. by Murray PR, Weber CJ.; 1983 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=270953

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Recent Emergence of an Epidemic Clindamycin-Resistant Clone of Clostridium difficile among Polish Patients with C. difficile-Associated Diarrhea. by Pituch H, van Belkum A, van den Braak N, Obuch-Woszczatynski P, Verbrugh H, Meisel-Mikolajczyk F, Luczak M.; 2003 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=193821

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Reduction of wall degradability of clindamycin-treated staphylococci within macrophages. by Wecke J, Johannsen L, Giesbrecht P.; 1990 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=258429

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Relationship between antibiotic concentration in bone and efficacy of treatment of staphylococcal osteomyelitis in rats: azithromycin compared with clindamycin and rifampin. by O'Reilly T, Kunz S, Sande E, Zak O, Sande MA, Tauber MG.; 1992 Dec; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=245530

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Resistance to tetracycline, erythromycin, and clindamycin in the Bacteroides fragilis group: inducible versus constitutive tetracycline resistance. by Privitera G, Fayolle F, Sebald M.; 1981 Sep; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=181693

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Sequence homology of clindamycin resistance determinants in clinical isolates of Bacteroides spp. by Marsh PK, Malamy MH, Shimell MJ, Tally FP.; 1983 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=184800

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Streptococcus pneumoniae and Streptococcus pyogenes resistant to macrolides but sensitive to clindamycin: a common resistance pattern mediated by an efflux system. by Sutcliffe J, Tait-Kamradt A, Wondrack L.; 1996 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163423

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Subinhibitory Clindamycin Differentially Inhibits Transcription of Exoprotein Genes in Staphylococcus aureus. by Herbert S, Barry P, Novick RP.; 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=98253

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Susceptibilities of 428 gram-positive and -negative anaerobic bacteria to Bay y3118 compared with their susceptibilities to ciprofloxacin, clindamycin, metronidazole,

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piperacillin, piperacillin-tazobactam, and cefoxitin. by Pankuch GA, Jacobs MR, Appelbaum PC.; 1993 Aug; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188035 •

Susceptibilities of 540 anaerobic gram-negative bacilli to amoxicillin, amoxicillinBRL 42715, amoxicillin-clavulanate, temafloxacin, and clindamycin. by Appelbaum PC, Spangler SK, Shiman R, Jacobs MR.; 1992 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=188852

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Susceptibilities of Campylobacter jejuni Isolates from Germany to Ciprofloxacin, Moxifloxacin, Erythromycin, Clindamycin, and Tetracycline. by Wagner J, Jabbusch M, Eisenblatter M, Hahn H, Wendt C, Ignatius R.; 2003 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=161846

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Susceptibility of Neisseria gonorrhoeae associated with pelvic inflammatory disease to cefoxitin, ceftriaxone, clindamycin, gentamicin, doxycycline, azithromycin, and other antimicrobial agents. by Rice RJ, Knapp JS.; 1994 Jul; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=284620

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Susceptibility of penicillin-susceptible and -resistant pneumococci to dirithromycin compared with susceptibilities to erythromycin, azithromycin, clarithromycin, roxithromycin, and clindamycin. by Visalli MA, Jacobs MR, Appelbaum PC.; 1997 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=164026

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Synergism between penicillin, clindamycin, or metronidazole and gentamicin against species of the Bacteroides melaninogenicus and Bacteroides fragilis groups. by Brook I, Coolbaugh JC, Walker RI, Weiss E.; 1984 Jan; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=185438

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Synergistic Effect of Clindamycin and Atovaquone in Acute Murine Toxoplasmosis. by Djurkovic-Djakovic O, Nikolic T, Robert-Gangneux F, Bobic B, Nikolic A.; 1999 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=89454

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Therapeutic Responses to Quinine and Clindamycin in Multidrug-Resistant Falciparum Malaria. by Pukrittayakamee S, Chantra A, Vanijanonta S, Clemens R, Looareesuwan S, White NJ.; 2000 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=90075

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Three-Day Quinine-Clindamycin Treatment of Uncomplicated Falciparum Malaria Imported from the Tropics. by Adehossi E, Parola P, Foucault C, Delmont J, Brouqui P.; 2003 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149314

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Transferable Resistance to Clindamycin, Erythromycin, and Tetracycline in Clostridium difficile. by Wust J, Hardegger U.; 1983 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=184818

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Treatment with interleukin 12 in combination with atovaquone or clindamycin significantly increases survival of mice with acute toxoplasmosis. by Araujo FG, Hunter CA, Remington JS.; 1997 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163683

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Unusual susceptibility of methicillin-resistant Staphylococcus aureus to erythromycin, clindamycin, gentamicin, and tetracycline at 30 degrees C but not at 35 degrees C. by Welch WD, Southern PM.; 1984 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=271193

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Use of Clindamycin Disks To Detect Macrolide Resistance Mediated by ermB and mefE in Streptococcus pneumoniae Isolates from Adults and Children. by Waites K, Johnson C, Gray B, Edwards K, Crain M, Benjamin W Jr.; 2000 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=86572

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Variation in erythromycin and clindamycin susceptibilities of Streptococcus pneumoniae by four test methods. by Fasola EL, Bajaksouzian S, Appelbaum PC, Jacobs MR.; 1997 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163673

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Variation in postantibiotic effect of clindamycin against clinical isolates of Staphylococcus aureus and implications for dosing of patients with osteomyelitis. by Xue IB, Davey PG, Phillips G.; 1996 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163339

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with clindamycin, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “clindamycin” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for clindamycin (hyperlinks lead to article summaries):

6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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5-Fluoro-uracil-clindamycin for treatment of cerebral toxoplasmosis. Author(s): Dhiver C, Milandre C, Poizot-Martin I, Drogoul MP, Gastaut JL, Gastaut JA. Source: Aids (London, England). 1993 January; 7(1): 143-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8442914&dopt=Abstract

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A clinical comparison of cefepime and metronidazole versus gentamicin and clindamycin in the antibiotic management of surgically treated advanced appendicitis. Author(s): Berne TV, Yellin AE, Appleman MD, Heseltine PN, Gill MA. Source: Surg Gynecol Obstet. 1993; 177 Suppl: 18-22; Discussion 35-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8256187&dopt=Abstract

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A combination benzoyl peroxide and clindamycin topical gel compared with benzoyl peroxide, clindamycin phosphate, and vehicle in the treatment of acne vulgaris. Author(s): Tschen EH, Katz HI, Jones TM, Monroe EW, Kraus SJ, Connolly MA, Levy SF. Source: Cutis; Cutaneous Medicine for the Practitioner. 2001 February; 67(2): 165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11236229&dopt=Abstract

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A double-blind, multicenter comparative study of two regimens of clindamycin hydrochloride in the treatment of patients with acute streptococcal tonsillitis/pharyngitis. Author(s): Gallegos B, Rios A, Espidel A, Reynal JL. Source: Clinical Therapeutics. 1995 July-August; 17(4): 613-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8565025&dopt=Abstract

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A five-year multicenter study of the susceptibility of the Bacteroides fragilis group isolates to cephalosporins, cephamins, penicillins, clindamycin, and metronidazole in the United States. Author(s): Aldridge KE, Gelfand M, Reller LB, Ayers LW, Pierson CL, Schoenknecht F, Tilton RC, Wilkins J, Henderberg A, Schiro DD, et al. Source: Diagnostic Microbiology and Infectious Disease. 1994 April; 18(4): 235-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7924220&dopt=Abstract

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A multicenter study comparing intravenous meropenem with clindamycin plus gentamicin for the treatment of acute gynecologic and obstetric pelvic infections in hospitalized women. Author(s): Hemsell DL, Martens MG, Faro S, Gall S, McGregor JA. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 February; 24 Suppl 2: S222-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9126697&dopt=Abstract

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A multicentre, single-blind, randomized comparison of a fixed clindamycin phosphate/tretinoin gel formulation (Velac) applied once daily and a clindamycin lotion formulation (Dalacin T) applied twice daily in the topical treatment of acne vulgaris. Author(s): Zouboulis CC, Derumeaux L, Decroix J, Maciejewska-Udziela B, Cambazard F, Stuhlert A. Source: The British Journal of Dermatology. 2000 September; 143(3): 498-505. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971320&dopt=Abstract

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A new treatment for acne vulgaris combining benzoyl peroxide with clindamycin. Author(s): Tschen E, Jones T. Source: J Drugs Dermatol. 2002 September; 1(2): 153-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12847739&dopt=Abstract

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A randomised controlled trial of vaginal clindamycin for early pregnancy bacterial vaginosis. Author(s): Kurkinen-Raty M, Vuopala S, Koskela M, Kekki M, Kurki T, Paavonen J, Jouppila P. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 November; 107(11): 1427-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11117774&dopt=Abstract

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A randomized controlled trial of penicillin vs clindamycin for the treatment of aspiration pneumonia in children. Author(s): Jacobson SJ, Griffiths K, Diamond S, Winders P, Sgro M, Feldman W, Macarthur C. Source: Archives of Pediatrics & Adolescent Medicine. 1997 July; 151(7): 701-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9232045&dopt=Abstract

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A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching clindamycin gel with respect to microbiologic activity and clinical efficacy in the topical treatment of acne vulgaris. Author(s): Cunliffe WJ, Holland KT, Bojar R, Levy SF. Source: Clinical Therapeutics. 2002 July; 24(7): 1117-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182256&dopt=Abstract

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Absorption of clindamycin after intravaginal application of clindamycin phosphate 2% cream. Author(s): Borin MT, Powley GW, Tackwell KR, Batts DH. Source: The Journal of Antimicrobial Chemotherapy. 1995 June; 35(6): 833-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7559194&dopt=Abstract

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Activation of clindamycin phosphate by human skin. Author(s): Amr S, Brown MB, Martin GP, Forbes B. Source: Journal of Applied Microbiology. 2001 April; 90(4): 550-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11309066&dopt=Abstract

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Acute verapamil toxicity in a patient with chronic toxicity: possible interaction with ceftriaxone and clindamycin. Author(s): Kishore K, Raina A, Misra V, Jonas E. Source: The Annals of Pharmacotherapy. 1993 July-August; 27(7-8): 877-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8364267&dopt=Abstract

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Adverse cutaneous reactions to pyrimethamine/sulfadiazine and pyrimethamine/clindamycin in patients with AIDS and toxoplasmic encephalitis. Author(s): Caumes E, Bocquet H, Guermonprez G, Rogeaux O, Bricaire F, Katlama C, Gentilini M. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1995 September; 21(3): 656-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8527561&dopt=Abstract

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Ampicillin/sulbactam vs. clindamycin/gentamicin in the treatment of postpartum endometritis. Author(s): Gall S, Koukol DH. Source: J Reprod Med. 1996 August; 41(8): 575-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8866384&dopt=Abstract

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Anti-anaerobic activity of levofloxacin alone and combined with clindamycin and metronidazole. Author(s): Credito KL, Jacobs MR, Appelbaum PC. Source: Diagnostic Microbiology and Infectious Disease. 2000 November; 38(3): 181-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11109019&dopt=Abstract

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Antianaerobic activity of moxifloxacin compared with that of ofloxacin, ciprofloxacin, clindamycin, metronidazole and beta-lactams. Author(s): Behra-Miellet J, Dubreuil L, Jumas-Bilak E. Source: International Journal of Antimicrobial Agents. 2002 November; 20(5): 366-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12431872&dopt=Abstract

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Antibiotic-associated diarrhea in HIV-infected patients receiving clindamycin. Author(s): Slevogt H, Ruf B. Source: Infection. 1997 May-June; 25(3): 189. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9181391&dopt=Abstract

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Antimicrobial agents for the dermatologist. II. Macrolides, fluoroquinolones, rifamycins, tetracyclines, trimethoprim-sulfamethoxazole, and clindamycin. Author(s): Epstein ME, Amodio-Groton M, Sadick NS. Source: Journal of the American Academy of Dermatology. 1997 September; 37(3 Pt 1): 365-81; Quiz 382-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9308549&dopt=Abstract

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Antipneumococcal activities of a ketolide (HMR 3647), a streptogramin (quinupristindalfopristin), a macrolide (erythromycin), and a lincosamide (clindamycin). Author(s): Barry AL, Fuchs PC, Brown SD. Source: Antimicrobial Agents and Chemotherapy. 1998 April; 42(4): 945-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9559816&dopt=Abstract

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Are 2 combined antimicrobial mechanisms better than 1 for the treatment of acne vulgaris? Clinical and antimicrobial results of a topical combination product containing 1% clindamycin and 5% benzoyl peroxide. Introduction. Author(s): Leyden J. Source: Cutis; Cutaneous Medicine for the Practitioner. 2001 February; 67(2 Suppl): 5-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11236213&dopt=Abstract

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Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Author(s): McGregor JA, French JI, Jones W, Milligan K, McKinney PJ, Patterson E, Parker R. Source: American Journal of Obstetrics and Gynecology. 1994 April; 170(4): 1048-59; Discussion 1059-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8166188&dopt=Abstract

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Bacterial vaginosis-associated microflora and effects of topical intravaginal clindamycin. Author(s): Hill GB, Livengood CH 3rd. Source: American Journal of Obstetrics and Gynecology. 1994 November; 171(5): 1198204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7977519&dopt=Abstract

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Bactericidal activity of low-dose clindamycin administered at 8- and 12-hour intervals against Staphylococcus aureus, Streptococcus pneumoniae, and Bacteroides fragilis. Author(s): Klepser ME, Nicolau DP, Quintiliani R, Nightingale CH. Source: Antimicrobial Agents and Chemotherapy. 1997 March; 41(3): 630-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9056005&dopt=Abstract

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Bioavailability and selected pharmacokinetic parameters of clindamycin hydrochloride after administration of a new 600 mg tablet formulation. Author(s): Mazur D, Schug BS, Evers G, Larsimont V, Fieger-Buschges H, Gimbel W, Keilbach-Bermann A, Blume HH. Source: Int J Clin Pharmacol Ther. 1999 August; 37(8): 386-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10475141&dopt=Abstract

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Changes in the vaginal flora after two percent clindamycin vaginal cream in women at high risk of spontaneous preterm birth. Author(s): Vermeulen GM, van Zwet AA, Bruinse HW. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2001 July; 108(7): 697-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11467693&dopt=Abstract

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Changes in vaginal flora after 2% clindamycin vaginal cream in women at high risk of preterm birth. Author(s): Lamont DF. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 August; 110(8): 788-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12892701&dopt=Abstract

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Changes of the serum antibiotic levels during open heart surgery (ceftazidim, ciprofloxacin, clindamycin). Author(s): Lonsky V, Dominik J, Mand'ak J, Pozlerova E, Hejzlar M, Lonska V, Marsikova M, Kubicek J, Snitilova M. Source: Acta Medica (Hradec Kralove). 2000; 43(1): 23-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10934782&dopt=Abstract

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Characterization of bactericidal activity of clindamycin against Bacteroides fragilis via kill curve methods. Author(s): Klepser ME, Banevicius MA, Quintiliani R, Nightingale CH. Source: Antimicrobial Agents and Chemotherapy. 1996 August; 40(8): 1941-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8843310&dopt=Abstract

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Cholestatic liver disease with ductopenia (vanishing bile duct syndrome) after administration of clindamycin and trimethoprim-sulfamethoxazole. Author(s): Altraif I, Lilly L, Wanless IR, Heathcote J. Source: The American Journal of Gastroenterology. 1994 August; 89(8): 1230-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8053440&dopt=Abstract

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Clindamycin and metronidazole. Author(s): Falagas ME, Gorbach SL. Source: The Medical Clinics of North America. 1995 July; 79(4): 845-67. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7791427&dopt=Abstract

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Clindamycin and nicotinic neuromuscular transmission. Author(s): Schulze J, Toepfer M, Schroff KC, Aschhoff S, Remien J, Muller-Felber W, Endres S. Source: Lancet. 1999 November 20; 354(9192): 1792-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10577648&dopt=Abstract

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Clindamycin and primaquine therapy for mild-to-moderate episodes of Pneumocystis carinii pneumonia in patients with AIDS: AIDS Clinical Trials Group 044. Author(s): Black JR, Feinberg J, Murphy RL, Fass RJ, Finkelstein D, Akil B, Safrin S, Carey JT, Stansell J, Plouffe JF, et al. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1994 June; 18(6): 905-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8086551&dopt=Abstract

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Clindamycin and pseudomembranous colitis. Author(s): Riley TV, Golledge CL. Source: Lancet. 1995 September 2; 346(8975): 639. Erratum In: Lancet 1995 Sep 16; 346(8977): 784. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7651026&dopt=Abstract

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Clindamycin and pseudomembranous colitis. Author(s): Soto J. Source: Lancet. 1995 July 22; 346(8969): 249. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7616819&dopt=Abstract

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Clindamycin as an antimalarial drug: review of clinical trials. Author(s): Lell B, Kremsner PG. Source: Antimicrobial Agents and Chemotherapy. 2002 August; 46(8): 2315-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12121898&dopt=Abstract

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Clindamycin desensitization in an AIDS patient. Author(s): Marcos C, Sopena B, Luna I, Gonzalez R, de la Fuente J, Martinez-Vazquez C. Source: Aids (London, England). 1995 October; 9(10): 1201-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8519462&dopt=Abstract

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Clindamycin for intraincisional antibiotic prophylaxis in dermatologic surgery. Author(s): Huether MJ, Griego RD, Brodland DG, Zitelli JA. Source: Archives of Dermatology. 2002 September; 138(9): 1145-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12224974&dopt=Abstract

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Clindamycin hypersensitivity appears to be rare. Author(s): Mazur N, Greenberger PA, Regalado J. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 1999 May; 82(5): 443-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10353574&dopt=Abstract

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Clindamycin in combination with chloroquine or quinine is an effective therapy for uncomplicated Plasmodium falciparum malaria in children from Gabon. Author(s): Kremsner PG, Winkler S, Brandts C, Neifer S, Bienzle U, Graninger W. Source: The Journal of Infectious Diseases. 1994 February; 169(2): 467-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8106787&dopt=Abstract

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Clindamycin in dentistry. Author(s): van der Bijl P. Source: J Dent Assoc S Afr. 1994 November; 49(11): 563-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9508961&dopt=Abstract

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Clindamycin in persisting streptococcal pharyngotonsillitis after penicillin treatment. Author(s): Orrling A, Stjernquist-Desatnik A, Schalen C, Kamme C. Source: Scandinavian Journal of Infectious Diseases. 1994; 26(5): 535-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7855551&dopt=Abstract

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Clindamycin in recurrent group A streptococcal pharyngotonsillitis. An alternative to tonsillectomy? Author(s): Stjernquist-Desatnik A, Orrling A, Schalen C, Kamme C. Source: Advances in Experimental Medicine and Biology. 1997; 418: 435-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9331687&dopt=Abstract

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Clindamycin in recurrent group A streptococcal pharyngotonsillitis--an alternative to tonsillectomy? Author(s): Orrling A, Stjernquist-Desatnik A, Schalen C. Source: Acta Oto-Laryngologica. 1997 July; 117(4): 618-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9288223&dopt=Abstract

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Clindamycin in the treatment of streptococcal and staphylococcal toxic shock syndromes. Author(s): Russell NE, Pachorek RE. Source: The Annals of Pharmacotherapy. 2000 July-August; 34(7-8): 936-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10928407&dopt=Abstract

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Clindamycin or penicillin V? Author(s): Lung KE. Source: Journal (Canadian Dental Association). 1999 December; 65(11): 602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10658384&dopt=Abstract

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Clindamycin phosphate 1% gel in acne vulgaris. Author(s): Rizer RL, Sklar JL, Whiting D, Bucko A, Shavin J, Jarratt M. Source: Adv Ther. 2001 November-December; 18(6): 244-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11841194&dopt=Abstract

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Clindamycin plus amikacin versus clindamycin plus aztreonam in established intraabdominal infections. Author(s): Barboza E, del Castillo M, Yi A, Gotuzzo E. Source: Surgery. 1994 July; 116(1): 28-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8023265&dopt=Abstract

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Clindamycin promotes phagocytosis and intracellular killing of periodontopathogenic bacteria by crevicular granulocytes: an in vitro study. Author(s): Eick S, Pfister W, Fiedler D, Straube E. Source: The Journal of Antimicrobial Chemotherapy. 2000 October; 46(4): 583-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11020256&dopt=Abstract

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Clindamycin resistance among erythromycin-resistant Streptococcus pneumoniae. Author(s): Jones RN, Cormican MG, Wanger A. Source: Diagnostic Microbiology and Infectious Disease. 1996 August; 25(4): 201-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8937845&dopt=Abstract

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Clindamycin resistance in the Bacteroides fragilis group: association with hospitalacquired infections. Author(s): Dalmau D, Cayouette M, Lamothe F, Vincelette J, Lachance N, Bourgault AM, Gaudreau C, Turgeon PL. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 May; 24(5): 874-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9142785&dopt=Abstract

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Clindamycin resistant strains of Clostridium difficile isolated from cases of C. difficile associated diarrhea (CDAD) in a hospital in Sweden. Author(s): Noren T, Tang-Feldman YJ, Cohen SH, Silva J Jr, Olcen P. Source: Diagnostic Microbiology and Infectious Disease. 2002 February; 42(2): 149-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11858913&dopt=Abstract

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Clindamycin suppresses endotoxin released by ceftazidime-treated Escherichia coli O55:B5 and subsequent production of tumor necrosis factor alpha and interleukin-1 beta. Author(s): Kishi K, Hirai K, Hiramatsu K, Yamasaki T, Nasu M. Source: Antimicrobial Agents and Chemotherapy. 1999 March; 43(3): 616-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10049276&dopt=Abstract

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Clindamycin suspension and endocarditis prophylaxis. Author(s): Littler WA. Source: British Dental Journal. 2001 April 28; 190(8): 407. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11352383&dopt=Abstract

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Clindamycin therapy of experimental meningitis caused by penicillin- and cephalosporin-resistant Streptococcus pneumoniae. Author(s): Paris MM, Shelton S, Trujillo M, Hickey SM, McCracken GH Jr. Source: Antimicrobial Agents and Chemotherapy. 1996 January; 40(1): 122-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8787892&dopt=Abstract

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Clindamycin treatment of invasive infections caused by community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus in children. Author(s): Martinez-Aguilar G, Hammerman WA, Mason EO Jr, Kaplan SL. Source: The Pediatric Infectious Disease Journal. 2003 July; 22(7): 593-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867833&dopt=Abstract

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Clindamycin treatment of methicillin-resistant Staphylococcus aureus infections in children. Author(s): Frank AL, Marcinak JF, Mangat PD, Tjhio JT, Kelkar S, Schreckenberger PC, Quinn JP. Source: The Pediatric Infectious Disease Journal. 2002 June; 21(6): 530-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182377&dopt=Abstract

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Clindamycin treatment of Staphylococcus aureus expressing inducible clindamycin resistance. Author(s): Drinkovic D, Fuller ER, Shore KP, Holland DJ, Ellis-Pegler R. Source: The Journal of Antimicrobial Chemotherapy. 2001 August; 48(2): 315-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11481309&dopt=Abstract

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Clindamycin versus cloxacillin in the treatment of 240 open fractures. A randomized prospective study. Author(s): Vasenius J, Tulikoura I, Vainionpaa S, Rokkanen P. Source: Ann Chir Gynaecol. 1998; 87(3): 224-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9825068&dopt=Abstract

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Clindamycin with primaquine vs. Trimethoprim-sulfamethoxazole therapy for mild and moderately severe Pneumocystis carinii pneumonia in patients with AIDS: a multicenter, double-blind, randomized trial (CTN 004). CTN-PCP Study Group. Author(s): Toma E, Thorne A, Singer J, Raboud J, Lemieux C, Trottier S, Bergeron MG, Tsoukas C, Falutz J, Lalonde R, Gaudreau C, Therrien R. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1998 September; 27(3): 524-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9770152&dopt=Abstract

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Clindamycin, metronidazole, and chloramphenicol. Author(s): Kasten MJ. Source: Mayo Clinic Proceedings. 1999 August; 74(8): 825-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10473362&dopt=Abstract

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Clindamycin. Author(s): Weingarten-Arams J, Adam HM. Source: Pediatrics in Review / American Academy of Pediatrics. 2002 April; 23(4): 14950. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927749&dopt=Abstract

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Clindamycin. Author(s): Rosenberg MG. Source: Pediatrics in Review / American Academy of Pediatrics. 1996 October; 17(10): 373-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8885648&dopt=Abstract

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Clindamycin/benzoyl peroxide gel: a review of its use in the management of acne. Author(s): Warner GT, Plosker GL. Source: American Journal of Clinical Dermatology. 2002; 3(5): 349-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069641&dopt=Abstract

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Clindamycin/cefonicid in head and neck oncologic surgery: one-day prophylaxis is as effective as a three-day schedule. Author(s): Righi M, Manfredi R, Farneti G, Pasquini E, Romei Bugliari D, Cenacchi V. Source: J Chemother. 1995 June; 7(3): 216-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7562017&dopt=Abstract

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Clindamycin/primaquine as prophylaxis for Pneumocystis carinii pneumonia. Author(s): Barber BA, Pegram PS, High KP. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1996 October; 23(4): 718-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8909833&dopt=Abstract

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Clindamycin/primaquine versus trimethoprim-sulfamethoxazole as primary therapy for Pneumocystis carinii pneumonia in AIDS: a randomized, double-blind pilot trial. Author(s): Toma E, Fournier S, Dumont M, Bolduc P, Deschamps H. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1993 August; 17(2): 178-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399863&dopt=Abstract

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Clindamycin-associated acute generalized exanthematous pustulosis. Author(s): Valois M, Phillips EJ, Shear NH, Knowles SR. Source: Contact Dermatitis. 2003 March; 48(3): 169. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755740&dopt=Abstract

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Clindamycin-induced acute generalized exanthematous pustulosis. Author(s): Schwab RA, Vogel PS, Warschaw KE. Source: Cutis; Cutaneous Medicine for the Practitioner. 2000 June; 65(6): 391-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10879309&dopt=Abstract

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Clindamycin-induced lip and nasal passage swelling. Author(s): Segars LW, Threlkeld KR. Source: The Annals of Pharmacotherapy. 1993 July-August; 27(7-8): 885-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8364270&dopt=Abstract

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Clindamycin-induced neuromuscular blockade. Author(s): al Ahdal O, Bevan DR. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 July; 42(7): 614-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7553999&dopt=Abstract

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Clindamycin-resistant Bacillus endophthalmitis. Author(s): Sakamoto TK, Cruess AF, Zoutman DE, Evans GA. Source: Can J Ophthalmol. 1993 December; 28(7): 339-42. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8313222&dopt=Abstract

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Clindamycin-resistant, toxin A-negative, toxin B-positive Clostridium difficile strains cause antibiotic-associated diarrhea among children hospitalized in a hematology unit. Author(s): Pituch H, vavn Belkum A, van den Braak N, Obuch-Woszczatynski P, Sawicka-Grzelak A, Verbrugh H, Meisel-Mikolajczyk F, Luczak M. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2003 August; 9(8): 903-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14616719&dopt=Abstract

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Clinical and economic impact of a pharmacist-intervention to promote sequential intravenous to oral clindamycin conversion. Author(s): Martinez MJ, Freire A, Castro I, Inaraja MT, Ortega A, Del Campo V, Rodriguez I, Bardan B, Morano LE, Garcia JF. Source: Pharmacy World & Science : Pws. 2000 April; 22(2): 53-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10849923&dopt=Abstract

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Clinical efficacy of Velac, a new tretinoin and clindamycin phosphate gel in acne vulgaris. Author(s): Cambazard F. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 1998 September; 11 Suppl 1: S20-7; Discussion S28-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9891905&dopt=Abstract

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Clinical resistance to erythromycin and clindamycin in cutaneous propionibacteria isolated from acne patients is associated with mutations in 23S rRNA. Author(s): Ross JI, Eady EA, Cove JH, Jones CE, Ratyal AH, Miller YW, Vyakrnam S, Cunliffe WJ. Source: Antimicrobial Agents and Chemotherapy. 1997 May; 41(5): 1162-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9145890&dopt=Abstract

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Clostridium difficile toxin-induced colitis after use of clindamycin phosphate vaginal cream. Author(s): Meadowcroft AM, Diaz PR, Latham GS. Source: The Annals of Pharmacotherapy. 1998 March; 32(3): 309-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9533061&dopt=Abstract

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Clostridium difficile-associated diarrhea after short term vaginal administration of clindamycin. Author(s): Vikenes K, Lund-Tonnesen S, Schreiner A. Source: The American Journal of Gastroenterology. 1999 July; 94(7): 1969-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10406271&dopt=Abstract

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Comment: clindamycin meta-analysis. Author(s): Gill MA. Source: The Annals of Pharmacotherapy. 1996 May; 30(5): 548-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8740346&dopt=Abstract

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Comment: verapamil interaction with ceftriaxone and clindamycin. Author(s): Lugo RA, Nahata MC. Source: The Annals of Pharmacotherapy. 1993 December; 27(12): 1544-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8305797&dopt=Abstract

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Community-acquired and clindamycin-susceptible methicillin-resistant Staphylococcus aureus in children. Author(s): Frank AL, Marcinak JF, Mangat PD, Schreckenberger PC. Source: The Pediatric Infectious Disease Journal. 1999 November; 18(11): 993-1000. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10571437&dopt=Abstract

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Comparative efficacy of clindamycin and benzoyl peroxide for in vivo suppression of Propionibacterium acnes. Author(s): Gans EH, Kligman AM. Source: The Journal of Dermatological Treatment. 2002 September; 13(3): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12227872&dopt=Abstract

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Comparative efficacy of oral doses of clindamycin and erythromycin in the prevention of bacteraemia. Author(s): Aitken C, Cannell H, Sefton AM, Kerawala C, Seymour A, Murphy M, Whiley RA, Williams JD. Source: British Dental Journal. 1995 June 10; 178(11): 418-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7599015&dopt=Abstract

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Comparative study of bioavailabilities and pharmacokinetics of clindamycin in healthy volunteers and patients with AIDS. Author(s): Gatti G, Flaherty J, Bubp J, White J, Borin M, Gambertoglio J. Source: Antimicrobial Agents and Chemotherapy. 1993 May; 37(5): 1137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8517703&dopt=Abstract

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Comparative study of ceftriaxone versus cefazolin plus clindamycin as antibiotic prophylaxis in elective colorectal surgery. Author(s): Mecchia P. Source: J Chemother. 2000 September; 12 Suppl 3: 5-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11432682&dopt=Abstract

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Comparison of ampicillin/sulbactam plus aminoglycoside vs. ampicillin plus clindamycin plus aminoglycoside in the treatment of intraabdominal infections in children. The Multicenter Group. Author(s): Collins MD, Dajani AS, Kim KS, King DR, Kaplan SL, Azimi PH, Kolokathis A, Swanson R. Source: The Pediatric Infectious Disease Journal. 1998 March; 17(3 Suppl): S15-8; Discussion S20-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9519910&dopt=Abstract

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Comparison of ampicillin/sulbactam versus clindamycin in the prevention of infection in patients undergoing head and neck surgery. Author(s): Johnson JT, Kachman K, Wagner RL, Myers EN. Source: Head & Neck. 1997 August; 19(5): 367-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9243262&dopt=Abstract

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Comparison of cefoperazone plus sulbactam with clindamycin plus gentamicin as treatment for intra-abdominal infections. Author(s): Greenberg RN, Cayavec P, Danko LS, Bowen K, Montazemi R, Kearney PA, Johnson SB, Strodel WE. Source: The Journal of Antimicrobial Chemotherapy. 1994 September; 34(3): 391-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7829413&dopt=Abstract

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Comparison of clindamycin phosphate vaginal cream with triple sulfonamide vaginal cream in the treatment of bacterial vaginosis. Author(s): McCormack WM, Covino JM, Thomason JL, Eschenbach DA, Mou S, Kapernick P, McGregor J, Rein MF, Hillier SL. Source: Sexually Transmitted Diseases. 2001 October; 28(10): 569-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11689755&dopt=Abstract

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Comparison of imipenem/cilastatin with the combination of aztreonam and clindamycin in the treatment of intra-abdominal infections. Author(s): de Groot HG, Hustinx PA, Lampe AS, Oosterwijk WM. Source: The Journal of Antimicrobial Chemotherapy. 1993 September; 32(3): 491-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8262872&dopt=Abstract

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Comparison of mutants of Toxoplasma gondii selected for resistance to azithromycin, spiramycin, or clindamycin. Author(s): Pfefferkorn ER, Borotz SE. Source: Antimicrobial Agents and Chemotherapy. 1994 January; 38(1): 31-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8141576&dopt=Abstract

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Comparison of the efficacy and safety of a combination topical gel formulation of benzoyl peroxide and clindamycin with benzoyl peroxide, clindamycin and vehicle gel in the treatments of acne vulgaris. Author(s): Leyden JJ, Berger RS, Dunlap FE, Ellis CN, Connolly MA, Levy SF. Source: American Journal of Clinical Dermatology. 2001; 2(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11702619&dopt=Abstract

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Comparison of three regimens for treatment of mild to moderate Pneumocystis carinii pneumonia in patients with AIDS. A double-blind, randomized, trial of oral trimethoprim-sulfamethoxazole, dapsone-trimethoprim, and clindamycinprimaquine. ACTG 108 Study Group. Author(s): Safrin S, Finkelstein DM, Feinberg J, Frame P, Simpson G, Wu A, Cheung T, Soeiro R, Hojczyk P, Black JR. Source: Annals of Internal Medicine. 1996 May 1; 124(9): 792-802. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8610948&dopt=Abstract

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Contact dermatitis from clindamycin. Author(s): Vejlstrup E, Menne T. Source: Contact Dermatitis. 1995 February; 32(2): 110. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7758308&dopt=Abstract

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Controlled trial of 3-day quinine-clindamycin treatment versus 7-day quinine treatment for adult travelers with uncomplicated falciparum malaria imported from the tropics. Author(s): Parola P, Ranque S, Badiaga S, Niang M, Blin O, Charbit JJ, Delmont J, Brouqui P. Source: Antimicrobial Agents and Chemotherapy. 2001 March; 45(3): 932-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11181383&dopt=Abstract

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Cost analysis of imipenem-cilastatin versus clindamycin with tobramycin in the treatment of acute intra-abdominal infection. Author(s): de Lissovoy G, Elixhauser A, Luce BR, Weschler J, Mowery P, Reblando J, Solomkin J. Source: Pharmacoeconomics. 1993 September; 4(3): 203-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10146923&dopt=Abstract

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Cross-resistance to beta-lactam-beta-lactamase inhibitor combinations and clindamycin among cefoxitin-resistant and cefoxitin-susceptible strains of the Bacteroides fragilis group. Author(s): Aldridge KE. Source: Diagnostic Microbiology and Infectious Disease. 1993 October; 17(3): 251-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8112038&dopt=Abstract

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Curing of chloroquine-resistant malaria with clindamycin. Author(s): Kremsner PG, Winkler S, Brandts C, Graninger W, Bienzle U. Source: The American Journal of Tropical Medicine and Hygiene. 1993 November; 49(5): 650-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8250107&dopt=Abstract

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Cutaneous adverse reactions to clindamycin: results of skin tests and oral exposure. Author(s): Lammintausta K, Tokola R, Kalimo K. Source: The British Journal of Dermatology. 2002 April; 146(4): 643-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11966697&dopt=Abstract

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Dalacin C advertisement. Author(s): Lung KE. Source: Journal (Canadian Dental Association). 1999 July-August; 65(7): 375. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10465914&dopt=Abstract

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Decrease in nosocomial Clostridium difficile-associated diarrhea by restricting clindamycin use. Author(s): Pear SM, Williamson TH, Bettin KM, Gerding DN, Galgiani JN. Source: Annals of Internal Medicine. 1994 February 15; 120(4): 272-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8080497&dopt=Abstract

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Delayed allergic reactions to amoxycillin and clindamycin. Author(s): Garcia R, Galindo PA, Feo F, Gomez E, Fernandez F. Source: Contact Dermatitis. 1996 August; 35(2): 116-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8917841&dopt=Abstract

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Delayed reaction to oral treatment with clindamycin. Author(s): Vicente J, Fontela JL. Source: Contact Dermatitis. 1999 October; 41(4): 221. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10515103&dopt=Abstract

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Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Author(s): Sobel JD. Source: American Journal of Obstetrics and Gynecology. 1994 November; 171(5): 121520. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7977522&dopt=Abstract

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Determination of clindamycin in human plasma by high-performance liquid chromatography using coupled columns. Author(s): Fieger-Buschges H, Schussler G, Larsimont V, Blume H. Source: J Chromatogr B Biomed Sci Appl. 1999 March 19; 724(2): 281-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10219669&dopt=Abstract

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Determination of clindamycin in human plasma by liquid chromatographyelectrospray tandem mass spectrometry: application to the bioequivalence study of clindamycin. Author(s): Yu LL, Chao CK, Liao WJ, Twu TY, Liu CM, Yang TH, Lin ET. Source: J Chromatogr B Biomed Sci Appl. 1999 March 19; 724(2): 287-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10219670&dopt=Abstract

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Development of a clindamycin-impregnated fiber as an intracanal medication in endodontic therapy. Author(s): Gilad JZ, Teles R, Goodson M, White RR, Stashenko P. Source: Journal of Endodontics. 1999 November; 25(11): 722-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10726537&dopt=Abstract

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Development of interpretive criteria and quality control limits for macrolide and clindamycin susceptibility testing of Streptococcus pneumoniae. Author(s): Jorgensen JH, Swenson JM, Tenover FC, Barry A, Ferraro MJ, Murray PR, Reller LB. Source: Journal of Clinical Microbiology. 1996 November; 34(11): 2679-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8897164&dopt=Abstract

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Development of liposome encapsulated clindamycin for treatment of acne vulgaris. Author(s): Honzak L, Sentjurc M. Source: Pflugers Archiv : European Journal of Physiology. 2000; 440(5 Suppl): R44-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005607&dopt=Abstract

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Differential inhibition by clindamycin on slime formation, adherence to teflon catheters and hemolysin production by Staphylococcus epidermidis. Author(s): Shibl AM, Ramadan MA, Tawfik AF. Source: J Chemother. 1994 April; 6(2): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8077984&dopt=Abstract

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Diversity of ribosomal mutations conferring resistance to macrolides, clindamycin, streptogramin, and telithromycin in Streptococcus pneumoniae. Author(s): Canu A, Malbruny B, Coquemont M, Davies TA, Appelbaum PC, Leclercq R. Source: Antimicrobial Agents and Chemotherapy. 2002 January; 46(1): 125-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751122&dopt=Abstract

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Early postpartum endometritis. Randomized comparison of ampicillin/sulbactam vs. ampicillin, gentamicin and clindamycin. Author(s): Resnik E, Harger JH, Kuller JA. Source: J Reprod Med. 1994 June; 39(6): 467-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7932402&dopt=Abstract

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Effect of amoxicillin or clindamycin on the adenoids bacterial flora. Author(s): Brook I, Shah K. Source: Otolaryngology and Head and Neck Surgery. 2003 July; 129(1): 5-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12869909&dopt=Abstract

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Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. Author(s): Ugwumadu A, Manyonda I, Reid F, Hay P. Source: Lancet. 2003 March 22; 361(9362): 983-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660054&dopt=Abstract

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Effect of intravaginal clindamycin cream on pregnancy outcome and on abnormal vaginal microbial flora of pregnant women. Author(s): Rosenstein IJ, Morgan DJ, Lamont RF, Sheehan M, Dore CJ, Hay PE, TaylorRobinson D. Source: Infectious Diseases in Obstetrics and Gynecology. 2000; 8(3-4): 158-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10968599&dopt=Abstract

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Effect of oral clindamycin on late miscarriage and preterm delivery. Author(s): Tarnow-Mordi W, Isaacs D, Gilbert G, Athayde N, Stanley F. Source: Lancet. 2003 June 21; 361(9375): 2161; Author Reply 2162. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826465&dopt=Abstract

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Effect of oral clindamycin on late miscarriage and preterm delivery. Author(s): Althabe F, Bergel E, Belizan JM, Barros FC. Source: Lancet. 2003 June 21; 361(9375): 2161; Author Reply 2162. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826464&dopt=Abstract

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Effect of recombinant human granulocyte colony-stimulating factor on combination therapy with aztreonam and clindamycin for infections in neutropenic patients with hematologic diseases. Author(s): Toyama K, Yaguchi M, Mizoguchi H, Masuda M, Urabe A, Ikeda Y, Aoki I, Shinbo T, Togawa A, Hirashima K, Miura Y, Hirose S, Tsuruoka N, Omine M, Kamakura M, Saito T, Arimori S, Aoki N, Kuraishi Y, Hirai H, Asano S, Mori M, Shirai T, Muto Y, Takaku F, et al. Source: Kansenshogaku Zasshi. 1996 December; 70(12): 1242-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9011117&dopt=Abstract

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Effect of topical benzoyl peroxide/clindamycin versus topical clindamycin and vehicle in the reduction of Propionibacterium acnes. Author(s): Leyden JJ. Source: Cutis; Cutaneous Medicine for the Practitioner. 2002 June; 69(6): 475-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12078851&dopt=Abstract

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Effect of vaccination therapy for acne, using a staphylococci antigenic complex in combination with clindamycin. Author(s): Jautova J, Dorko E, Pilipcinec E, Tkacikova L. Source: Folia Microbiol (Praha). 2003; 48(2): 249-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800511&dopt=Abstract

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Efficacy and tolerability of combined topical treatment of acne vulgaris with adapalene and clindamycin: a multicenter, randomized, investigator-blinded study. Author(s): Wolf JE Jr, Kaplan D, Kraus SJ, Loven KH, Rist T, Swinyer LJ, Baker MD, Liu YS, Czernielewski J. Source: Journal of the American Academy of Dermatology. 2003 September; 49(3 Suppl): S211-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963897&dopt=Abstract

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Efficacy of clindamycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis. Author(s): Fischbach F, Petersen EE, Weissenbacher ER, Martius J, Hosmann J, Mayer H. Source: Obstetrics and Gynecology. 1993 September; 82(3): 405-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8355942&dopt=Abstract

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Efficacy of clindamycin vaginal ovule (3-day treatment) vs. clindamycin vaginal cream (7-day treatment) in bacterial vaginosis. Author(s): Sobel J, Peipert JF, McGregor JA, Livengood C, Martin M, Robbins J, Wajszczuk CP. Source: Infectious Diseases in Obstetrics and Gynecology. 2001; 9(1): 9-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11368263&dopt=Abstract

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Efficacy of the combination of 2 g oral tinidazole and acidic buffering vaginal gel in comparison with vaginal clindamycin alone in bacterial vaginosis: a randomized, investigator-blinded, controlled trial. Author(s): Milani M, Barcellona E, Agnello A. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2003 July 1; 109(1): 67-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12818447&dopt=Abstract

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Efficacy of the fixed 1.2% clindamycin phosphate, 0.025% tretinoin gel formulation (Velac) and a proprietary 0.025% tretinoin gel formulation (Aberela) in the topical control of facial acne. Author(s): Richter JR, Forstrom LR, Kiistala UO, Jung EG. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 1998 November; 11(3): 227-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9883434&dopt=Abstract

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Efficacy of topical amoxicillin plus clavulanate/ticarcillin plus clavulanate and clindamycin in contaminated head and neck surgery: effect of antibiotic spectra and duration of therapy. Author(s): Grandis JR, Vickers RM, Rihs JD, Yu VL, Johnson JT. Source: The Journal of Infectious Diseases. 1994 September; 170(3): 729-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8077738&dopt=Abstract

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Elimination of bacteraemia after dental extraction: comparison of erythromycin and clindamycin for prophylaxis of infective endocarditis. Author(s): Hall G, Nord CE, Heimdahl A. Source: The Journal of Antimicrobial Chemotherapy. 1996 April; 37(4): 783-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8722544&dopt=Abstract

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Emergence of erythromycin-resistant, clindamycin-susceptible Streptococcus pyogenes isolates in Madrid, Spain. Author(s): Garcia-Bermejo I, Cacho J, Orden B, Alos JI, Gomez-Garces JL. Source: Antimicrobial Agents and Chemotherapy. 1998 April; 42(4): 989-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9559831&dopt=Abstract

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Endothelial cell compatibility of clindamycin, gentamicin, ceftriaxone and teicoplanin in Bier's arterial arrest. Author(s): Vorbach H, Robibaro B, Armbruster C, Atteneder M, Reiter M, Hlousek M, Schaumann R, Georgopoulos A. Source: The Journal of Antimicrobial Chemotherapy. 1999 August; 44(2): 275-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10473235&dopt=Abstract

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Epidemics of diarrhea caused by a clindamycin-resistant strain of Clostridium difficile in four hospitals. Author(s): Johnson S, Samore MH, Farrow KA, Killgore GE, Tenover FC, Lyras D, Rood JI, DeGirolami P, Baltch AL, Rafferty ME, Pear SM, Gerding DN. Source: The New England Journal of Medicine. 1999 November 25; 341(22): 1645-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10572152&dopt=Abstract

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Erythromycin and clindamycin resistance and telithromycin susceptibility in Streptococcus agalactiae. Author(s): Betriu C, Culebras E, Gomez M, Rodriguez-Avial I, Sanchez BA, Agreda MC, Picazo JJ. Source: Antimicrobial Agents and Chemotherapy. 2003 March; 47(3): 1112-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12604549&dopt=Abstract

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Evaluation of low-dose, extended-interval clindamycin regimens against Staphylococcus aureus and Streptococcus pneumoniae using a dynamic in vitro model of infection. Author(s): Lewis RE, Klepser ME, Ernst EJ, Lund BC, Biedenbach DJ, Jones RN. Source: Antimicrobial Agents and Chemotherapy. 1999 August; 43(8): 2005-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10428927&dopt=Abstract

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Failure of clindamycin to influence the course of severe oromucositis associated with streptococcal bacteraemia in allogeneic bone marrow transplant recipients. Author(s): Donnelly JP, Muus P, Horrevorts AM, Sauerwein RW, De Pauw BE. Source: Scandinavian Journal of Infectious Diseases. 1993; 25(1): 43-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8460348&dopt=Abstract

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Failure of clindamycin treatment of methicillin-resistant Staphylococcus aureus expressing inducible clindamycin resistance in vitro. Author(s): Siberry GK, Tekle T, Carroll K, Dick J. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 November 1; 37(9): 1257-60. Epub 2003 October 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14557972&dopt=Abstract

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Fox-Fordyce disease treated with topical clindamycin solution. Author(s): Miller ML, Harford RR, Yeager JK. Source: Archives of Dermatology. 1995 October; 131(10): 1112-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7574824&dopt=Abstract

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Frequent resistance of clinical group B streptococci isolates to clindamycin and erythromycin. Author(s): Pearlman MD, Pierson CL, Faix RG. Source: Obstetrics and Gynecology. 1998 August; 92(2): 258-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9699763&dopt=Abstract

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Fulminant babesiosis treated with clindamycin, quinine, and whole-blood exchange transfusion. Author(s): Dorman SE, Cannon ME, Telford SR 3rd, Frank KM, Churchill WH. Source: Transfusion. 2000 March; 40(3): 375-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10738042&dopt=Abstract

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Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream. Author(s): Trexler MF, Fraser TG, Jones MP. Source: The American Journal of Gastroenterology. 1997 November; 92(11): 2112-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9362204&dopt=Abstract

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Gentamicin and clindamycin therapy in postpartum endometritis: the efficacy of daily dosing versus dosing every 8 hours. Author(s): Livingston JC, Llata E, Rinehart E, Leidwanger C, Mabie B, Haddad B, Sibai B. Source: American Journal of Obstetrics and Gynecology. 2003 January; 188(1): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12548209&dopt=Abstract

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High prevalence of erythromycin-resistant and clindamycin-susceptible (M phenotype) viridans group streptococci from pharyngeal samples: a reservoir of mef genes in commensal bacteria. Author(s): Aracil B, Minambres M, Oteo J, Torres C, Gomez-Garces JL, Alos JI. Source: The Journal of Antimicrobial Chemotherapy. 2001 October; 48(4): 592-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11581247&dopt=Abstract

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High prevalence of erythromycin-resistant, clindamycin/miocamycin-susceptible (M phenotype) Streptococcus pyogenes: results of a Spanish multicentre study in 1998. Spanish Group for the Study of Infection in the Primary Health Care Setting. Author(s): Alos JI, Aracil B, Oteo J, Torres C, Gomez-Garces JL. Source: The Journal of Antimicrobial Chemotherapy. 2000 May; 45(5): 605-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797081&dopt=Abstract

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High prevalence of resistance to clindamycin in Bacteroides fragilis group isolates. Author(s): Oteo J, Aracil B, Alos JI, Gomez-Garces JL. Source: The Journal of Antimicrobial Chemotherapy. 2000 May; 45(5): 691-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797095&dopt=Abstract

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High-performance liquid chromatographic determination of clindamycin in human plasma or serum: application to the bioequivalency study of clindamycin phosphate injections. Author(s): Liu CM, Chen YK, Yang TH, Hsieh SY, Hung MH, Lin ET. Source: J Chromatogr B Biomed Sci Appl. 1997 August 29; 696(2): 298-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9323551&dopt=Abstract

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Hospital-wide restriction of clindamycin: effect on the incidence of Clostridium difficile-associated diarrhea and cost. Author(s): Climo MW, Israel DS, Wong ES, Williams D, Coudron P, Markowitz SM. Source: Annals of Internal Medicine. 1998 June 15; 128(12 Pt 1): 989-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9625685&dopt=Abstract

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Hypersensitivity reaction to intravitreal clindamycin therapy. Author(s): Kim P, Younan N, Coroneo MT. Source: Clinical & Experimental Ophthalmology. 2002 April; 30(2): 147-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11886422&dopt=Abstract

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Immunomodulatory effects of tretinoin in combination with clindamycin. Author(s): Wauben-Penris PJ, Cerneus DP, van den Hoven WE, Leuven PJ, den Brok JH, Hall DW. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 1998 September; 11 Suppl 1: S2-7; Discussion S28-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9891902&dopt=Abstract

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Impact of a target drug monitoring program on the usage of clindamycin. Author(s): Gin AS, Lipinski LA, Honcharik N. Source: Can J Hosp Pharm. 1994 April; 47(2): 53-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10134127&dopt=Abstract

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Improved outcome of clindamycin compared with beta-lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Author(s): Zimbelman J, Palmer A, Todd J. Source: The Pediatric Infectious Disease Journal. 1999 December; 18(12): 1096-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10608632&dopt=Abstract

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In vitro activities of ketolide HMR 3647, macrolides, and clindamycin against Coryneform bacteria. Author(s): Martinez-Martinez L, Pascual A, Suarez AI, Perea EJ. Source: Antimicrobial Agents and Chemotherapy. 1998 December; 42(12): 3290-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9835530&dopt=Abstract

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In vitro and in vivo effects of penicillin and clindamycin on expression of group A beta-hemolytic streptococcal capsule. Author(s): Brook I, Gober AE, Leyva F. Source: Antimicrobial Agents and Chemotherapy. 1995 July; 39(7): 1565-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7492105&dopt=Abstract

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In vitro and in vivo synergy of fosmidomycin, a novel antimalarial drug, with clindamycin. Author(s): Wiesner J, Henschker D, Hutchinson DB, Beck E, Jomaa H. Source: Antimicrobial Agents and Chemotherapy. 2002 September; 46(9): 2889-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12183243&dopt=Abstract

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In vitro assays elucidate peculiar kinetics of clindamycin action against Toxoplasma gondii. Author(s): Fichera ME, Bhopale MK, Roos DS. Source: Antimicrobial Agents and Chemotherapy. 1995 July; 39(7): 1530-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7492099&dopt=Abstract

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In vitro development of resistance to telithromycin (HMR 3647), four macrolides, clindamycin, and pristinamycin in Streptococcus pneumoniae. Author(s): Davies TA, Dewasse BE, Jacobs MR, Appelbaum PC. Source: Antimicrobial Agents and Chemotherapy. 2000 February; 44(2): 414-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10639373&dopt=Abstract

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In vitro interaction between clindamycin and trimethoprim in combination on staphylococci. Author(s): el-Baz W, Abd-el Hamid T, Tantawi A, Sabbour MS. Source: Int J Clin Pharmacol Res. 1993; 13(3): 187-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8225702&dopt=Abstract

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In vitro selection of resistance to clindamycin related to alterations in the attenuator of the erm(TR) gene of Streptococcus pyogenes UCN1 inducibly resistant to erythromycin. Author(s): Fines M, Gueudin M, Ramon A, Leclercq R. Source: The Journal of Antimicrobial Chemotherapy. 2001 September; 48(3): 411-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11533008&dopt=Abstract

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In vivo potentiation of polymorphonuclear leukocyte chemotaxis by clindamycin. Author(s): Skoutelis AT, Lianou PE, Bassaris HP. Source: Infection. 1993 September-October; 21(5): 321-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8300250&dopt=Abstract

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Incidence of diarrhea and Clostridium difficile toxin in stools from hospitalized patients receiving clindamycin, beta-lactams, or nonantibiotic medications. Author(s): Thamlikitkul V, Danpakdi K, Chokloikaew S. Source: Journal of Clinical Gastroenterology. 1996 March; 22(2): 161-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8742665&dopt=Abstract

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Increased resistance of encapsulated Bacteroides fragilis to clindamycin. Author(s): Brook I, Gillmore JD. Source: Chemotherapy. 1994 January-February; 40(1): 16-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8306810&dopt=Abstract

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Influences of linezolid, penicillin, and clindamycin, alone and in combination, on streptococcal pyrogenic exotoxin a release. Author(s): Coyle EA, Cha R, Rybak MJ. Source: Antimicrobial Agents and Chemotherapy. 2003 May; 47(5): 1752-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709354&dopt=Abstract

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Intravaginal clindamycin to reduce preterm birth in women with abnormal genital tract flora. Author(s): Lamont RF, Duncan SL, Mandal D, Bassett P. Source: Obstetrics and Gynecology. 2003 March; 101(3): 516-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12636956&dopt=Abstract

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Intravaginal clindamycin treatment for bacterial vaginosis: effects on preterm delivery and low birth weight. Author(s): Joesoef MR, Hillier SL, Wiknjosastro G, Sumampouw H, Linnan M, Norojono W, Idajadi A, Utomo B. Source: American Journal of Obstetrics and Gynecology. 1995 November; 173(5): 152731. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7503196&dopt=Abstract

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Intravitreal clindamycin and dexamethasone for toxoplasmic retinochoroiditis. Author(s): Kishore K, Conway MD, Peyman GA. Source: Ophthalmic Surgery and Lasers. 2001 May-June; 32(3): 183-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11371084&dopt=Abstract

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In-vitro activity of three fluoroquinolones, cefotaxime and clindamycin against staphylococci. Author(s): Schumacher-Perdreau F, Peters G. Source: Zentralbl Bakteriol. 1995 October; 282(4): 389-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9810661&dopt=Abstract

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In-vitro effects of penicillin and clindamycin on the expression of Streptococcus pneumoniae capsule. Author(s): Brook I, Gober AE. Source: Journal of Medical Microbiology. 1996 December; 45(6): 505-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8958258&dopt=Abstract

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Long-term follow-up of patients with bacterial vaginosis treated with oral metronidazole and topical clindamycin. Author(s): Sobel JD, Schmitt C, Meriwether C. Source: The Journal of Infectious Diseases. 1993 March; 167(3): 783-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8440952&dopt=Abstract

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Lymphadenitis associated with the administration of clindamycin. Author(s): Southern PM Jr. Source: The American Journal of Medicine. 1997 August; 103(2): 164-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9274901&dopt=Abstract

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Macrolides and clindamycin suppress the release of Shiga-like toxins from Escherichia coli O157:H7 in vitro. Author(s): Murakami J, Kishi K, Hirai K, Hiramatsu K, Yamasaki T, Nasu M. Source: International Journal of Antimicrobial Agents. 2000 July; 15(2): 103-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10854805&dopt=Abstract

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Meropenem versus tobramycin plus clindamycin for treatment of intraabdominal infections: results of a prospective, randomized, double-blind clinical trial. Author(s): Condon RE, Walker AP, Sirinek KR, White PW, Fabian TC, Nichols RL, Wilson SE. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1995 September; 21(3): 544-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8527541&dopt=Abstract

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Meropenem versus tobramycin with clindamycin in the antibiotic management of patients with advanced appendicitis. Author(s): Berne TV, Yellin AE, Appleman MD, Heseltine PN, Gill MA. Source: Journal of the American College of Surgeons. 1996 May; 182(5): 403-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8620275&dopt=Abstract

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Meta-analysis of parenteral clindamycin dosing regimens. Author(s): Rovers JP, Ilersich AL, Einarson TR. Source: The Annals of Pharmacotherapy. 1995 September; 29(9): 852-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8547731&dopt=Abstract

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MIC and serum bactericidal activity of clindamycin against methicillin-resistant and sensitive staphylococci. Author(s): Lemmen S, Kropec A, Engels I, Busse A, Daschner FD. Source: Infection. 1993 November-December; 21(6): 407-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8132374&dopt=Abstract

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Mucosal concentration and excretion of clindamycin by the human stomach. Author(s): Hextall A, Radley S, Andrews JM, Boyd EJ, Dent JC, Donovan I, Wise R. Source: The Journal of Antimicrobial Chemotherapy. 1994 March; 33(3): 595-602. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8040123&dopt=Abstract

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Neuromuscular blockade after clindamycin administration: a case report. Author(s): Best JA, Marashi AH, Pollan LD. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 1999 May; 57(5): 600-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10319836&dopt=Abstract

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Neutropenia after single-dose clindamycin for dental prophylaxis. Author(s): Bubalo JS, Blasdel CS, Bearden DT. Source: Pharmacotherapy. 2003 January; 23(1): 101-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523467&dopt=Abstract

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Nodular cutaneous microsporidiosis in a patient with AIDS and successful treatment with long-term oral clindamycin therapy. Author(s): Kester KE, Turiansky GW, McEvoy PL. Source: Annals of Internal Medicine. 1998 June 1; 128(11): 911-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9634430&dopt=Abstract

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Nosocomial outbreak of Clostridium difficile-associated diarrhoea due to a clindamycin-resistant enterotoxin A-negative strain. Author(s): Kuijper EJ, de Weerdt J, Kato H, Kato N, van Dam AP, van der Vorm ER, Weel J, van Rheenen C, Dankert J. Source: European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology. 2001 August; 20(8): 528-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11681431&dopt=Abstract

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Odontogenic infections and clindamycin. Author(s): Sands T, Pynn BR. Source: Univ Tor Dent J. 1995; 9(1): 32-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9584795&dopt=Abstract

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Oral clindamycin and ciprofloxacin versus intramuscular ceftriaxone and oral doxycycline in the treatment of mild-to-moderate pelvic inflammatory disease in outpatients. Author(s): Arredondo JL, Diaz V, Gaitan H, Maradiegue E, Oyarzun E, Paz R, Reynal JL, Stamm W, Zambrano D. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 February; 24(2): 170-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9114143&dopt=Abstract

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Oral versus intraperitoneal application of clindamycin in tunnel infections: a prospective, randomized study in CAPD patients. Author(s): Plum J, Artik S, Busch T, Sahin K, Grabensee B. Source: Perit Dial Int. 1997 September-October; 17(5): 486-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9358531&dopt=Abstract

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Penetration of clindamycin and its metabolite N-demethylclindamycin into cerebrospinal fluid following intravenous infusion of clindamycin phosphate in patients with AIDS. Author(s): Gatti G, Malena M, Casazza R, Borin M, Bassetti M, Cruciani M. Source: Antimicrobial Agents and Chemotherapy. 1998 November; 42(11): 3014-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9797245&dopt=Abstract

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Penetration of clindamycin and metronidazole into inflamed appendiceal tissue. Author(s): Levy Y, Berger SA, Gorea A, Shnaker A, Orda R. Source: The European Journal of Surgery = Acta Chirurgica. 1996 August; 162(8): 633-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8891621&dopt=Abstract

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Penicillin and clindamycin differentially inhibit the production of pyrogenic exotoxins A and B by group A streptococci. Author(s): Mascini EM, Jansze M, Schouls LM, Verhoef J, Van Dijk H. Source: International Journal of Antimicrobial Agents. 2001 October; 18(4): 395-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11691576&dopt=Abstract

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Perioperative antibiotic prophylaxis in maxillofacial surgery: penetration of clindamycin into various tissues. Author(s): Mueller SC, Henkel KO, Neumann J, Hehl EM, Gundlach KK, Drewelow B. Source: Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery. 1999 June; 27(3): 172-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10442308&dopt=Abstract

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Persistence of Plasmodium falciparum in the placenta after apparently effective quinidine/clindamycin therapy. Author(s): Procop GW, Jessen R, Hyde SR, Scheck DN. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2001 March; 21(2): 128-30. Review. Erratum In: J Perinatol 2001 July-August; 21(5): 347. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11324359&dopt=Abstract

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Pharmacoeconomics of aztreonam-clindamycin versus gentamicin-clindamycin in the treatment of penetrating abdominal injury. Author(s): Fabian TC, Boucher BA, Croce MC. Source: Pharmacotherapy. 1996 September-October; 16(5): 951-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8888092&dopt=Abstract

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Piperacillin and tazobactam versus clindamycin and gentamicin in the treatment of hospitalized women with pelvic infection. The Piperacillin/tazobactam Study Group. Author(s): Sweet RL, Roy S, Faro S, O'Brien WF, Sanfilippo JS, Seidlin M. Source: Obstetrics and Gynecology. 1994 February; 83(2): 280-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8290195&dopt=Abstract

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Piperacillin/tazobactam in comparison with clindamycin plus gentamicin in the treatment of intra-abdominal infections. Author(s): Shyr YM, Lui WY, Su CH, Wang LS, Liu CY. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1995 August; 56(2): 102-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7553416&dopt=Abstract

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Placebo-controlled trial of intravaginal clindamycin 2% cream for the treatment of bacterial vaginosis. Author(s): Stein GE, Christensen SL, Mummaw NL, Soper DE. Source: The Annals of Pharmacotherapy. 1993 November; 27(11): 1343-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8286805&dopt=Abstract

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Possible interaction between clindamycin and cyclosporin. Author(s): Thurnheer R, Laube I, Speich R. Source: Bmj (Clinical Research Ed.). 1999 July 17; 319(7203): 163. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10406753&dopt=Abstract

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Potential patient preference for 3-day treatment of bacterial vaginosis: responses to new suppository form of clindamycin. Author(s): Broumas AG, Basara LA. Source: Adv Ther. 2000 May-June; 17(3): 159-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11183453&dopt=Abstract

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Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci. Author(s): Fiebelkorn KR, Crawford SA, McElmeel ML, Jorgensen JH. Source: Journal of Clinical Microbiology. 2003 October; 41(10): 4740-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14532213&dopt=Abstract

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Preliminary results of a nonrandomized, multicenter, open-label study of patient satisfaction after treatment with combination benzoyl peroxide/clindamycin topical gel for mild to moderate acne. Author(s): Weiss JW, Shavin J, Davis M. Source: Clinical Therapeutics. 2002 October; 24(10): 1706-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12462298&dopt=Abstract

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Prevention of dry socket with clindamycin. A retrospective study. Author(s): Kupfer SR. Source: The New York State Dental Journal. 1995 June-July; 61(6): 30-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7624100&dopt=Abstract

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Primary suture of anorectal abscess. A randomized study comparing treatment with clindamycin vs. clindamycin and Gentacoll. Author(s): Mortensen J, Kraglund K, Klaerke M, Jaeger G, Svane S, Bone J. Source: Diseases of the Colon and Rectum. 1995 April; 38(4): 398-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7720448&dopt=Abstract

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Prolongation of rapacuronium neuromuscular blockade by clindamycin and magnesium. Author(s): Sloan PA, Rasul M. Source: Anesthesia and Analgesia. 2002 January; 94(1): 123-4, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772813&dopt=Abstract

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Prophylactic administration of clindamycin 2% vaginal cream to reduce the incidence of spontaneous preterm birth in women with an increased recurrence risk: a randomised placebo-controlled double-blind trial. Author(s): Vermeulen GM, Bruinse HW. Source: British Journal of Obstetrics and Gynaecology. 1999 July; 106(7): 652-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10428520&dopt=Abstract

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Prophylactic administration of clindamycin 2% vaginal cream to reduce the incidence of spontaneous preterm birth in women with an increased risk: a randomised placebo-controlled double-blind trial. Author(s): Mason MR, Adrinkra PE, Lamont RF. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 February; 107(2): 295-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10688520&dopt=Abstract

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Prophylactic single-dose administration of 600 mg clindamycin versus 4-time administration of 600 mg clindamycin in orthognathic surgery: A prospective randomized study in bilateral mandibular sagittal ramus osteotomies. Author(s): Lindeboom JA, Baas EM, Kroon FH. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2003 February; 95(2): 145-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582352&dopt=Abstract

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Prospective randomized study of two different doses of clindamycin admixed with gentamicin in the management of perforated appendicitis. Author(s): Yellin AE, Berne TV, Heseltine PN, Appleman MD, Gill M, Chin A, Baker FJ. Source: The American Surgeon. 1993 April; 59(4): 248-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8489087&dopt=Abstract

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Protein binding of clindamycin in sera of patients with AIDS. Author(s): Flaherty JF Jr, Gatti G, White J, Bubp J, Borin M, Gambertoglio JG. Source: Antimicrobial Agents and Chemotherapy. 1996 May; 40(5): 1134-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8723453&dopt=Abstract

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Pyrimethamine-clindamycin vs. pyrimethamine-sulfadiazine as acute and long-term therapy for toxoplasmic encephalitis in patients with AIDS. Author(s): Katlama C, De Wit S, O'Doherty E, Van Glabeke M, Clumeck N. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1996 February; 22(2): 268-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8838183&dopt=Abstract

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Quantitative analysis of clindamycin in human plasma by liquid chromatography/electrospray ionisation tandem mass spectrometry using d1-Nethylclindamycin as internal standard. Author(s): Rechberger GN, Fauler G, Windischhofer W, Kofeler H, Erwa W, Leis HJ. Source: Rapid Communications in Mass Spectrometry : Rcm. 2003; 17(2): 135-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12512092&dopt=Abstract

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Quinine plus clindamycin improves chemotherapy of severe malaria in children. Author(s): Kremsner PG, Radloff P, Metzger W, Wildling E, Mordmuller B, Philipps J, Jenne L, Nkeyi M, Prada J, Bienzle U, et al. Source: Antimicrobial Agents and Chemotherapy. 1995 July; 39(7): 1603-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7492113&dopt=Abstract

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Randomized comparative trial of imipenem/cilastatin versus aminoglycoside plus amoxycillin plus clindamycin in the treatment of severe intra- and post-operative infections. Author(s): Cakmakci M, Stern A, Schilling J, Christen D, Roggo A, Geroulanos S. Source: Drugs Exp Clin Res. 1993; 19(5): 223-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8174495&dopt=Abstract

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Randomized comparison of ampicillin-sulbactam to cefoxitin and doxycycline or clindamycin and gentamicin in the treatment of pelvic inflammatory disease or endometritis. Author(s): McGregor JA, Crombleholme WR, Newton E, Sweet RL, Tuomala R, Gibbs RS. Source: Obstetrics and Gynecology. 1994 June; 83(6): 998-1004. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8190448&dopt=Abstract

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Randomized comparison of quinine-clindamycin versus artesunate in the treatment of falciparum malaria in pregnancy. Author(s): McGready R, Cho T, Samuel, Villegas L, Brockman A, van Vugt M, Looareesuwan S, White NJ, Nosten F. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2001 November-December; 95(6): 651-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11816439&dopt=Abstract

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Rapid increase of resistance to erythromycin and clindamycin in Streptococcus pyogenes in Italy, 1993-1995. The Italian Surveillance Group for Antimicrobial Resistance. Author(s): Cornaglia G, Ligozzi M, Mazzariol A, Valentini M, Orefici G, Fontana R. Source: Emerging Infectious Diseases. 1996 October-December; 2(4): 339-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9011381&dopt=Abstract

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Recent appearance of clindamycin resistance in community-acquired methicillinresistant Staphylococcus aureus (MRSA) in south-east Queensland. Author(s): Munckhof WJ, Harper J, Schooneveldt J, Nimmo GR. Source: The Medical Journal of Australia. 2002 March 4; 176(5): 243-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11999249&dopt=Abstract

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Recent emergence of an epidemic clindamycin-resistant clone of Clostridium difficile among Polish patients with C. difficile-associated diarrhea. Author(s): Pituch H, Van Belkum A, Van Den Braak N, Obuch-Woszczatynski P, Verbrugh H, Meisel-Mikolajczyk F, uczak M. Source: Journal of Clinical Microbiology. 2003 September; 41(9): 4184-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12958245&dopt=Abstract

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Recurrent bacterial vaginosis unresponsive to metronidazole: successful treatment with oral clindamycin. Author(s): Tepper RS, Ives TJ, Kebede M. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1994 September-October; 7(5): 431-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7810359&dopt=Abstract

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Resistance to erythromycin and clindamycin in cutaneous propionibacteria is associated with mutations in 23S rRNA. Author(s): Ross JI, Eady EA, Cove JH, Ratyal AH, Cunliffe WJ. Source: Dermatology (Basel, Switzerland). 1998; 196(1): 69-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9557230&dopt=Abstract

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Results of a randomized, multicenter trial of meropenem versus clindamycin/tobramycin for the treatment of intra-abdominal infections. Author(s): Wilson SE. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 February; 24 Suppl 2: S197-206. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9126694&dopt=Abstract

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Sensitive and specific determination of clindamycin in human serum and bone tissue applying liquid chromatography-atmospheric pressure chemical ionization-mass spectrometry. Author(s): Martens-Lobenhoffer J, Banditt P. Source: J Chromatogr B Biomed Sci Appl. 2001 May 5; 755(1-2): 143-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11393698&dopt=Abstract

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Serum concentrations and ex vivo inhibitory/bactericidal activity of clindamycin after administration of two oral dosages. Author(s): Dan M, Yampolsky E, Poch F. Source: Chemotherapy. 1997 July-August; 43(4): 227-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9209778&dopt=Abstract

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Short-term effects of the clindamycin-steroid regimen in the treatment of ocular toxoplasmosis. Author(s): Djurkovic-Djakovic O, Stanojevic-Paovic A, Bobic B, Bergam J, Nikolic A, Paovic J, Vukovic D. Source: J Chemother. 1995 November; 7 Suppl 4: 199-201. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8904155&dopt=Abstract

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Should clindamycin be used as treatment of patients with infections caused by erythromycin-resistant staphylococci? Author(s): Panagea S, Perry JD, Gould FK. Source: The Journal of Antimicrobial Chemotherapy. 1999 October; 44(4): 581-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10588329&dopt=Abstract

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Should clindamycin be used in treatment of patients with infections caused by erythromycin-resistant staphylococci? Author(s): Rao GG. Source: The Journal of Antimicrobial Chemotherapy. 2000 May; 45(5): 715. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797103&dopt=Abstract

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Significant increase in the prevalence of erythromycin-resistant, clindamycin- and miocamycin-susceptible (M phenotype) Streptococcus pyogenes in Spain. Author(s): Alos JI, Aracil B, Oteo J, Gomez-Garces JL; Spanish Group for the Study of Infection in the Primary Health Care Setting (IAP-SEIMC). Source: The Journal of Antimicrobial Chemotherapy. 2003 February; 51(2): 333-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562699&dopt=Abstract

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Successful management of ocular toxoplasmosis during pregnancy using combined intraocular clindamycin and dexamethasone with systemic sulfadiazine. Author(s): Martinez CE, Zhang D, Conway MD, Peyman GA. Source: International Ophthalmology. 1998-99; 22(2): 85-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10472767&dopt=Abstract

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Sulfadoxine/pyrimethamine or chloroquine/clindamycin treatment of Gabonese school children infected with chloroquine resistant malaria. Author(s): Metzger W, Mordmuller B, Graninger W, Bienzle U, Kremsner PG. Source: The Journal of Antimicrobial Chemotherapy. 1995 October; 36(4): 723-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8591949&dopt=Abstract

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Superiority of aztreonam/clindamycin compared with gentamicin/clindamycin in patients with penetrating abdominal trauma. Author(s): Fabian TC, Hess MM, Croce MA, Wilson RS, Wilson SE, Charland SL, Rodman JH, Boucher BA. Source: American Journal of Surgery. 1994 March; 167(3): 291-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8160899&dopt=Abstract

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Susceptibilities of Campylobacter jejuni isolates from Germany to ciprofloxacin, moxifloxacin, erythromycin, clindamycin, and tetracycline. Author(s): Wagner J, Jabbusch M, Eisenblatter M, Hahn H, Wendt C, Ignatius R. Source: Antimicrobial Agents and Chemotherapy. 2003 July; 47(7): 2358-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821499&dopt=Abstract

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Susceptibility of Neisseria gonorrhoeae associated with pelvic inflammatory disease to cefoxitin, ceftriaxone, clindamycin, gentamicin, doxycycline, azithromycin, and other antimicrobial agents. Author(s): Rice RJ, Knapp JS. Source: Antimicrobial Agents and Chemotherapy. 1994 July; 38(7): 1688-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7979312&dopt=Abstract

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Symposium on antimicrobial therapy. X. Chloramphenicol, clindamycin, and metronidazole. Author(s): Greenfield RA. Source: J Okla State Med Assoc. 1993 July; 86(7): 336-41. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8229358&dopt=Abstract

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Synergic activity, for anaerobes, of trovafloxacin with clindamycin or metronidazole: chequerboard and time-kill methods. Author(s): Ednie LM, Credito KL, Khantipong M, Jacobs MR, Appelbaum PC. Source: The Journal of Antimicrobial Chemotherapy. 2000 May; 45(5): 633-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10797085&dopt=Abstract

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Systemic absorption of clindamycin after intravaginal administration of clindamycin phosphate ovule or cream. Author(s): Borin MT, Ryan KK, Hopkins NK. Source: Journal of Clinical Pharmacology. 1999 August; 39(8): 805-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10434232&dopt=Abstract

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The combination formulation of clindamycin 1% plus benzoyl peroxide 5% versus 3 different formulations of topical clindamycin alone in the reduction of Propionibacterium acnes. An in vivo comparative study. Author(s): Leyden J, Kaidbey K, Levy SF. Source: American Journal of Clinical Dermatology. 2001; 2(4): 263-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11705253&dopt=Abstract

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The effect of clindamycin gel insert in periodontal pockets, as observed on smears and cultures. Author(s): Sauvetre E, Glupczynsky Y, Labbe M, Yourassowsky E, Pourtois M. Source: Infection. 1993 July-August; 21(4): 245-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8225629&dopt=Abstract

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The effect of oral decontamination with clindamycin palmitate on the incidence of bacteremia after esophageal dilation: a prospective trial. Author(s): Hirota WK, Wortmann GW, Maydonovitch CL, Chang AS, Midkiff RB, Wong RK, Moses FM. Source: Gastrointestinal Endoscopy. 1999 October; 50(4): 475-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10502166&dopt=Abstract

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The efficacy and safety of a combination benzoyl peroxide/clindamycin topical gel compared with benzoyl peroxide alone and a benzoyl peroxide/erythromycin combination product. Author(s): Leyden JJ, Hickman JG, Jarratt MT, Stewart DM, Levy SF. Source: Journal of Cutaneous Medicine and Surgery. 2001 January-February; 5(1): 37-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11281433&dopt=Abstract

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The inhibitory effect of clindamycin on Lactobacillus in vitro. Author(s): Aroutcheva A, Simoes JA, Shott S, Faro S. Source: Infectious Diseases in Obstetrics and Gynecology. 2001; 9(4): 239-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11916182&dopt=Abstract

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The potential effect on Neisseria gonorrhoeae of the use of clindamycin vaginal cream in the empirical treatment of vaginal discharge. Author(s): Adu-Sarkodie YA, Brook MG, Clark S, Bendall R, Kell PD, Atia WA, Kelsey MC. Source: The Journal of Antimicrobial Chemotherapy. 1995 September; 36(3): 557-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8830022&dopt=Abstract

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The treatment of bacterial vaginosis with a 3 day course of 2% clindamycin cream: results of a multicentre, double blind, placebo controlled trial. B V Investigators Group. Author(s): Ahmed-Jushuf IH, Shahmanesh M, Arya OP. Source: Genitourinary Medicine. 1995 August; 71(4): 254-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7590720&dopt=Abstract

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The use of intradiscal antibiotics for discography: an in vitro study of gentamicin, cefazolin, and clindamycin. Author(s): Klessig HT, Showsh SA, Sekorski A. Source: Spine. 2003 August 1; 28(15): 1735-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897501&dopt=Abstract

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Therapeutic efficacy of clindamycin in combination with quinine for treating uncomplicated malaria in a village dispensary in Gabon. Author(s): Vaillant M, Millet P, Luty A, Tshopamba P, Lekoulou F, Mayombo J, Georges AJ, Deloron P. Source: Tropical Medicine & International Health : Tm & Ih. 1997 September; 2(9): 917-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9315051&dopt=Abstract

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Therapeutic responses to quinine and clindamycin in multidrug-resistant falciparum malaria. Author(s): Pukrittayakamee S, Chantra A, Vanijanonta S, Clemens R, Looareesuwan S, White NJ. Source: Antimicrobial Agents and Chemotherapy. 2000 September; 44(9): 2395-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10952585&dopt=Abstract

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Therapeutic studies with a new combination benzoyl peroxide/clindamycin topical gel in acne vulgaris. Author(s): Ellis CN, Leyden J, Katz HI, Goldfarb MT, Hickman J, Jones TM, Tschen E. Source: Cutis; Cutaneous Medicine for the Practitioner. 2001 February; 67(2 Suppl): 1320. Erratum In: Cutis 2001 March; 67(3): 257. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11236210&dopt=Abstract

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Three-day quinine-clindamycin treatment of uncomplicated falciparum malaria imported from the tropics. Author(s): Adehossi E, Parola P, Foucault C, Delmont J, Brouqui P, Badiaga S, Ranque S. Source: Antimicrobial Agents and Chemotherapy. 2003 March; 47(3): 1173. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12604566&dopt=Abstract

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Three-dose vs extended-course clindamycin prophylaxis for free-flap reconstruction of the head and neck. Author(s): Carroll WR, Rosenstiel D, Fix JR, de la Torre J, Solomon JS, Brodish B, Rosenthal EL, Heinz T, Niwas S, Peters GE. Source: Archives of Otolaryngology--Head & Neck Surgery. 2003 July; 129(7): 771-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12874080&dopt=Abstract

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Ticarcillin/clavulanate compared with clindamycin/gentamicin (with or without ampicillin) for the treatment of intra-abdominal infections in pediatric and adult patients. Author(s): Dougherty SH, Sirinek KR, Schauer PR, Fink MP, Fabian TC, Martin DH, Wiedermann B. Source: The American Surgeon. 1995 April; 61(4): 297-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7893090&dopt=Abstract

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Tissue concentration of clindamycin and gentamicin near ischaemic ulcers with transvenous injection in Bier's arterial arrest. Author(s): Burgmann H, Georgopoulos A, Graninger W, Koppensteiner R, Maca T, Minar E, Schneider B, Stumpflen A, Ehringer H. Source: Lancet. 1996 September 21; 348(9030): 781-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8813984&dopt=Abstract

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Tissue penetration of clindamycin in diabetic foot infections. Author(s): Duckworth C, Fisher JF, Carter SA, Newman CL, Cogburn C, Nesbit RR, Wray CH. Source: The Journal of Antimicrobial Chemotherapy. 1993 April; 31(4): 581-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8514652&dopt=Abstract

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Topical clindamycin versus systemic tetracycline in the treatment of hidradenitis suppurativa. Author(s): Jemec GB, Wendelboe P. Source: Journal of the American Academy of Dermatology. 1998 December; 39(6): 971-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9843011&dopt=Abstract

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Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Author(s): Shalita AR, Smith JG, Parish LC, Sofman MS, Chalker DK. Source: International Journal of Dermatology. 1995 June; 34(6): 434-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7657446&dopt=Abstract

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Toxic epidermal necrolysis following clindamycin treatment. Author(s): Paquet P, Schaaf-Lafontaine N, Pierard GE. Source: The British Journal of Dermatology. 1995 April; 132(4): 665-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7748763&dopt=Abstract

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Toxicity of clindamycin and primaquine treatment of AIDS-related Pneumocystis carinii pneumonia. Author(s): Smith N, Blanshard C, Smith D, Gazzard B. Source: Aids (London, England). 1993 May; 7(5): 749-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8318188&dopt=Abstract

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Transdermal absorption of clindamycin and tretinoin from topically applied antiacne formulations in man. Author(s): van Hoogdalem EJ, Baven TL, Spiegel-Melsen I, Terpstra IJ. Source: Biopharmaceutics & Drug Disposition. 1998 December; 19(9): 563-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9872337&dopt=Abstract

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Treatment of acne vulgaris: combination of 3% erythromycin and 5% benzoyl peroxide in a gel compared to clindamycin phosphate lotion. Author(s): Packman AM, Brown RH, Dunlap FE, Kraus SJ, Webster GF. Source: International Journal of Dermatology. 1996 March; 35(3): 209-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8655242&dopt=Abstract

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Treatment of acne with a combination clindamycin/benzoyl peroxide gel compared with clindamycin gel, benzoyl peroxide gel and vehicle gel: combined results of two double-blind investigations. Author(s): Lookingbill DP, Chalker DK, Lindholm JS, Katz HI, Kempers SE, Huerter CJ, Swinehart JM, Schelling DJ, Klauda HC. Source: Journal of the American Academy of Dermatology. 1997 October; 37(4): 590-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9344199&dopt=Abstract

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Treatment of bacterial vaginosis with a three day course of 2% clindamycin vaginal cream: a pilot study. Author(s): Dhar J, Arya OP, Timmins DJ, Moss S, Mukembo S, Alawattegama AB, Williams O. Source: Genitourinary Medicine. 1994 April; 70(2): 121-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8206470&dopt=Abstract

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Treatment of bacterial vaginosis: a comparison of oral metronidazole, metronidazole vaginal gel, and clindamycin vaginal cream. Author(s): Ferris DG, Litaker MS, Woodward L, Mathis D, Hendrich J. Source: The Journal of Family Practice. 1995 November; 41(5): 443-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7595261&dopt=Abstract

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Treatment of Legionella pneumophila lung abscess with clindamycin. Author(s): Buggy BP, Saravolatz LD. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1995 May; 20(5): 1158-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7619992&dopt=Abstract

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Treatment of post-cesarean section endometritis with ampicillin and sulbactam or clindamycin and gentamicin. Author(s): Stovall TG, Thorpe EM Jr, Ling FW. Source: J Reprod Med. 1993 November; 38(11): 843-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8277478&dopt=Abstract

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Treatment of rosacea: topical clindamycin versus oral tetracycline. Author(s): Wilkin JK, DeWitt S. Source: International Journal of Dermatology. 1993 January; 32(1): 65-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8425809&dopt=Abstract

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Treatment of Toxoplasma brain abscess with clindamycin and sulfadiazine in an AIDS patient with concurrent atypical Pneumocystis carinii pneumonia. Author(s): Tsai HC, Lee SS, Lin HH, Lin WR, Chen YS, Huang CK, Liu YC, Chen ER. Source: J Formos Med Assoc. 2002 September; 101(9): 646-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12645193&dopt=Abstract

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Treatment with 2% clindamycin vaginal cream prior to first trimester surgical abortion to reduce signs of postoperative infection: a prospective, double-blinded, placebo-controlled, multicenter study. Author(s): Larsson PG, Platz-Christensen JJ, Dalaker K, Eriksson K, Fahraeus L, Irminger K, Jerve F, Stray-Pedersen B, Wolner-Hanssen P. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2000 May; 79(5): 390-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10830767&dopt=Abstract

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Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. Author(s): Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Source: Journal of Human Lactation : Official Journal of International Lactation Consultant Association. 2001 February; 17(1): 54-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11847854&dopt=Abstract

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Use of clindamycin disks To detect macrolide resistance mediated by ermB and mefE in Streptococcus pneumoniae isolates from adults and children. Author(s): Waites K, Johnson C, Gray B, Edwards K, Crain M, Benjamin W Jr. Source: Journal of Clinical Microbiology. 2000 May; 38(5): 1731-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10790089&dopt=Abstract

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Vaginal clindamycin and oral metronidazole for bacterial vaginosis: a randomized trial. Author(s): Paavonen J, Mangioni C, Martin MA, Wajszczuk CP. Source: Obstetrics and Gynecology. 2000 August; 96(2): 256-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10908773&dopt=Abstract

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Vaginal clindamycin in preventing preterm birth and peripartal infections in asymptomatic women with bacterial vaginosis: a randomized, controlled trial. Author(s): Kekki M, Kurki T, Pelkonen J, Kurkinen-Raty M, Cacciatore B, Paavonen J. Source: Obstetrics and Gynecology. 2001 May; 97(5 Pt 1): 643-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11339909&dopt=Abstract

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Variation in postantibiotic effect of clindamycin against clinical isolates of Staphylococcus aureus and implications for dosing of patients with osteomyelitis. Author(s): Xue IB, Davey PG, Phillips G. Source: Antimicrobial Agents and Chemotherapy. 1996 June; 40(6): 1403-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8726009&dopt=Abstract

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Ventricular fibrillation due to long QT syndrome probably caused by clindamycin. Author(s): Gabel A, Schymik G, Mehmel HC. Source: The American Journal of Cardiology. 1999 March 1; 83(5): 813-5, A11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10080451&dopt=Abstract

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CHAPTER 2. NUTRITION AND CLINDAMYCIN Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and clindamycin.

Finding Nutrition Studies on Clindamycin The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “clindamycin” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “clindamycin” (or a synonym): •

Effect of clindamycin given alone or with Lactobacillus delbrueckii and Streptococcus thermophilus on 7alpha-dehydroxylation of bile acids in rats. Author(s): Laboratory of Medical Microbial Ecology, Department of Cell and Molecular Biology, Doktorsringen 4 A, Karolinska Institute, S-171 77 Stockholm (Sweden) Source: Gustafsson, A. Norin, E. Midtvedt, T. Clinical-Microbiology-and-Infection (United Kingdom). (1998). volume 4(10) page 594-598.

Additional physician-oriented references include: •

A clinical trial comparing the safety and efficacy of a topical erythromycin-zinc formulation with a topical clindamycin formulation. Author(s): Department of Dermatology and Cutaneous Surgery, University of Miami Medical School, FL 33101. Source: Schachner, L Pestana, A Kittles, C J-Am-Acad-Dermatol. 1990 March; 22(3): 48995 0190-9622

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Clindamycin as an antimalarial drug: review of clinical trials. Author(s): Medical Research Unit, Albert Schweitzer Hospital, Lambarene, Gabon. Source: Lell, B Kremsner, P G Antimicrob-Agents-Chemother. 2002 August; 46(8): 231520 0066-4804

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Clindamycin-induced alteration of ganglionic function. I. Direct effects on ganglion cell properties. Author(s): Department of Anatomy and Neurobiology, College of Medicine, University of Vermont, Burlington 05405. Source: Konopka, L M Parsons, R L Brain-Res. 1988 August 23; 458(2): 269-77 0006-8993

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Clinical efficacy of Velac, a new tretinoin and clindamycin phosphate gel in acne vulgaris. Author(s): C.H.U. de Saint Etienne, Department of Dermatology, France. Source: Cambazard, F J-Eur-Acad-Dermatol-Venereol. 1998 September; 11 Suppl 1S20-7; discussion S28-9 0926-9959

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Comparison of imipenem/cilastatin with the combination of aztreonam and clindamycin in the treatment of intra-abdominal infections. Author(s): Department of Surgery, Leyenburg Municipal Hospital, The Hague, The Netherlands. Source: de Groot, H G Hustinx, P A Lampe, A S Oosterwijk, W M J-AntimicrobChemother. 1993 September; 32(3): 491-500 0305-7453

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Comparison of the efficacy of three different treatments with imipenem versus the classical clindamycin plus tobramycin in experimental peritonitis. Author(s): Virgen de la Arrixaca Hospital, Murcia, Spain. Source: Gomez, J Ros, J Ruiz, J Canteras, M Valdes, M Martin Luengo, F J-Chemother. 1991 December; 3(6): 367-71 1120-009X

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Double-blind randomized trial of bismuth subsalicylate and clindamycin for treatment of Helicobacter pylori infection. Author(s): Dept. of Medicine, St. Louis University School of Medicine 63104. Source: Westblom, T U Madan, E Subik, M A Duriex, D E Midkiff, B R Scand-JGastroenterol. 1992; 27(3): 249-52 0036-5521

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Efficacy and tolerability of imipenem-cilastatin versus clindamycin+gentamicin for serious pelvic infections. Author(s): Department of Obstetrics and Gynecology, George Washington University, Washington, D.C. Source: Larsen, J W Gabel Hughes, K Kreter, B Clin-Ther. 1992 Jan-February; 14(1): 90-6 0149-2918

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Efficacy of the fixed 1.2% clindamycin phosphate, 0.025% tretinoin gel formulation (Velac) and a proprietary 0.025% tretinoin gel formulation (Aberela) in the topical control of facial acne. Author(s): Yamanouchi Europe B.V., Medical Department Europe, Leiderdorp, The Netherlands. Source: Richter, J R Forstrom, L R Kiistala, U O Jung, E G J-Eur-Acad-DermatolVenereol. 1998 November; 11(3): 227-33 0926-9959

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Fulminant babesiosis treated with clindamycin, quinine, and whole-blood exchange transfusion. Author(s): Division of Hematology, Department of Medicine, and the Department of Pathology, Brigham and Women's Hospital, Boston, MA 02215, USA. Source: Dorman, S E Cannon, M E Telford, S R Frank, K M Churchill, W H Transfusion. 2000 March; 40(3): 375-80 0041-1132

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Immunomodulatory effects of tretinoin in combination with clindamycin. Author(s): Yamanouchi Europe B.V. Research Laboratories, Leiderdorp, The Netherlands. [email protected] Source: Wauben Penris, P J Cerneus, D P van den Hoven, W E Leuven, P J den Brok, J H Hall, D W J-Eur-Acad-Dermatol-Venereol. 1998 September; 11 Suppl 1S2-7; discussion S28-9 0926-9959

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Persistence of Plasmodium falciparum in the placenta after apparently effective quinidine/clindamycin therapy. Author(s): Section of Microbiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Source: Procop, G W Jessen, R Hyde, S R Scheck, D N J-Perinatol. 2001 March; 21(2): 12830 0743-8346

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Prolongation of rapacuronium neuromuscular blockade by clindamycin and magnesium. Author(s): University of Kentucky College of Medicine, Lexington, Kentucky 40536, USA. [email protected] Source: Sloan, Paul A Rasul, Mazhar Anesth-Analg. 2002 January; 94(1): 123-4, table of contents 0003-2999

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Randomized comparative trial of imipenem/cilastatin versus aminoglycoside plus amoxycillin plus clindamycin in the treatment of severe intra- and post-operative infections. Author(s): Department of Surgery, University Hospital, Zurich, Switzerland. Source: Cakmakci, M Stern, A Schilling, J Christen, D Roggo, A Geroulanos, S DrugsExp-Clin-Res. 1993; 19(5): 223-7 0378-6501

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Randomized comparison of quinine-clindamycin versus artesunate in the treatment of falciparum malaria in pregnancy. Author(s): Shoklo Malaria Research Unit, P.O. Box 46, Mae Sot 63110, Thailand. Source: McGready, R Cho, T Samuel Villegas, L Brockman, A van Vugt, M Looareesuwan, S White, N J Nosten, F Trans-R-Soc-Trop-Med-Hyg. 2001 NovDecember; 95(6): 651-6 0035-9203

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Randomized trial of imipenem-cilastatin versus gentamicin plus clindamycin in the treatment of polymicrobial infections. Author(s): Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago 60612. Source: Danziger, L H Creger, R J Shwed, J A Stellato, T A Hau, T Pharmacotherapy. 1988; 8(6): 315-8 0277-0008

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Results of a multicenter trial comparing imipenem/cilastatin to tobramycin/clindamycin for intra-abdominal infections. Author(s): Department of Surgery, University of Cincinnati College of Medicine, Ohio 45267. Source: Solomkin, J S Dellinger, E P Christou, N V Busuttil, R W Ann-Surg. 1990 November; 212(5): 581-91 0003-4932

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Role of clindamycin in the treatment of acute toxoplasmosis of the central nervous system. Author(s): Department of Internal Medicine, Rudolf Virchow University Hospital (Wedding), Freie Universitat Berlin, FRG. Source: Ruf, B Pohle, H D Eur-J-Clin-Microbiol-Infect-Dis. 1991 March; 10(3): 183-6 09349723

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Short-term effects of the clindamycin-steroid regimen in the treatment of ocular toxoplasmosis. Author(s): Institute for Medical Research, University of Belgrade, Yugoslavia. Source: Djurkovic Djakovic, O Stanojevic Paovic, A Bobic, B Bergam, J Nikolic, A Paovic, J Vukovic, D J-Chemother. 1995 November; 7 Suppl 4199-201 1120-009X

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Synergism between clindamycin and colloidal bismuth subcitrate against Helicobacter (Campylobacter) pylori in vitro. Author(s): Institut fur Medizinische Mikrobiologie und Infektionsimmunologie der Freien Universitat, Berlin. Source: Vogt, K Hahn, H Zentralbl-Bakteriol. 1990 November; 274(2): 246-9 0934-8840

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Synergistic effect of clindamycin and atovaquone in acute murine toxoplasmosis. Author(s): Toxoplasmosis Research Laboratory, Institute for Medical Research, Belgrade, Yugoslavia. [email protected] Source: Djurkovic Djakovic, O Nikolic, T Robert Gangneux, F Bobic, B Nikolic, A Antimicrob-Agents-Chemother. 1999 September; 43(9): 2240-4 0066-4804

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The application of a semi-continuous colon simulation technique (Cositec) for studying the effects of clindamycin on microbial hindgut metabolism. Author(s): Institut fur Veterinar-Physiologie der Justus-Liebig-Universitat Giessen. Source: Stuck, K Faul, K Hylla, S Stein, J Breves, G Z-Gastroenterol. 1995 May; 33(5): 2416 0044-2771

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The inhibitory effect of clindamycin on Lactobacillus in vitro. Author(s): Department of Obstetrics and Gynecology, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL, USA. Source: Aroutcheva, A Simoes, J A Shott, S Faro, S Infect-Dis-Obstet-Gynecol. 2001; 9(4): 239-44 1064-7449

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Therapeutic responses to quinine and clindamycin in multidrug-resistant falciparum malaria. Author(s): Department of Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

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Source: Pukrittayakamee, S Chantra, A Vanijanonta, S Clemens, R Looareesuwan, S White, N J Antimicrob-Agents-Chemother. 2000 September; 44(9): 2395-8 0066-4804 •

Transdermal absorption of clindamycin and tretinoin from topically applied antiacne formulations in man. Author(s): Clinical Pharmacology Research Department, Yamanouchi Europe B.V., Leiderdorp, The Netherlands. [email protected] Source: van Hoogdalem, E J Baven, T L Spiegel Melsen, I Terpstra, I J Biopharm-DrugDispos. 1998 December; 19(9): 563-9 0142-2782

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMD®Health: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to clindamycin; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Vitamin K Source: Healthnotes, Inc.; www.healthnotes.com

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Minerals Zinc Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10071,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND CLINDAMYCIN Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to clindamycin. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to clindamycin and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “clindamycin” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to clindamycin: •

Antibiotic susceptibility testing of subgingival plaque samples. Author(s): Walker CB, Gordon JM, Socransky SS. Source: Journal of Clinical Periodontology. 1983 July; 10(4): 422-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6577034&dopt=Abstract

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Basic studies on ursodeoxycholyl-para-aminobenzoic acid for evaluation of intestinal microflora. Author(s): Takahashi M, Maeda Y, Tashiro H, Akazawa F, Okajima M, Yoshioka S, Matsugu Y, Toyota K, Masaoka Y. Source: Scandinavian Journal of Gastroenterology. 1991 June; 26(6): 577-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1862298&dopt=Abstract

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Clindamycin-induced neuromuscular blockade. Author(s): al Ahdal O, Bevan DR.

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Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 July; 42(7): 614-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7553999&dopt=Abstract •

Clostridium septicum abscess in hepatic metastases: successful medical management. Author(s): Thel MC, Ciaccia D, Vredenburgh JJ, Peters W, Corey GR. Source: Bone Marrow Transplantation. 1994 April; 13(4): 495-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7517261&dopt=Abstract

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Colonization for the prevention of Clostridium difficile disease in hamsters. Author(s): Sambol SP, Merrigan MM, Tang JK, Johnson S, Gerding DN. Source: The Journal of Infectious Diseases. 2002 December 15; 186(12): 1781-9. Epub 2002 November 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12447764&dopt=Abstract

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Effects of seven antibiotics on the growth and development of Phaenicia sericata (Diptera: Calliphoridae) larvae. Author(s): Sherman RA, Wyle FA, Thrupp L. Source: Journal of Medical Entomology. 1995 September; 32(5): 646-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7473619&dopt=Abstract

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Evaluation of antimicrobials combined with hyperbaric oxygen in a mouse model of clostridial myonecrosis. Author(s): Muhvich KH, Anderson LH, Mehm WJ. Source: The Journal of Trauma. 1994 January; 36(1): 7-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8295252&dopt=Abstract

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Evaluation of therapy with hyperbaric oxygen for experimental infection with Clostridium perfringens. Author(s): Stevens DL, Bryant AE, Adams K, Mader JT. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1993 August; 17(2): 231-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399871&dopt=Abstract

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Genotypic and phenotypic characterization of Helicobacter cinaedi and Helicobacter fennelliae strains isolated from humans and animals. Author(s): Kiehlbauch JA, Brenner DJ, Cameron DN, Steigerwalt AG, Makowski JM, Baker CN, Patton CM, Wachsmuth IK. Source: Journal of Clinical Microbiology. 1995 November; 33(11): 2940-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8576350&dopt=Abstract

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Intestinal bacteria and ulcerative colitis. Author(s): Cummings JH, Macfarlane GT, Macfarlane S.

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Source: Curr Issues Intest Microbiol. 2003 March; 4(1): 9-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691258&dopt=Abstract •

Neutropenia and fever in patients undergoing combination chemotherapy for malignant germ cell tumors of the ovary. Author(s): Chambers SK, Schwartz PE. Source: Obstetrics and Gynecology. 1986 December; 68(6): 842-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2431369&dopt=Abstract

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Nondigestible oligosaccharides enhance bacterial colonization resistance against Clostridium difficile in vitro. Author(s): Hopkins MJ, Macfarlane GT. Source: Applied and Environmental Microbiology. 2003 April; 69(4): 1920-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676665&dopt=Abstract

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Pharmacokinetic evaluation of a drug interaction between kaolin--pectin and clindamycin. Author(s): Albert KS, DeSante KA, Welch RD, DiSanto AR. Source: Journal of Pharmaceutical Sciences. 1978 November; 67(11): 1579-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=712595&dopt=Abstract

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Polyethyleneimine is an effective permeabilizer of gram-negative bacteria. Author(s): Helander IM, Alakomi HL, Latva-Kala K, Koski P. Source: Microbiology (Reading, England). 1997 October; 143 ( Pt 10): 3193-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9353921&dopt=Abstract

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Predominance of serotype V and frequency of erythromycin resistance in Streptococcus agalactiae in Ohio. Author(s): Croak A, Abate G, Goodrum K, Modrzakowski M. Source: American Journal of Obstetrics and Gynecology. 2003 May; 188(5): 1148-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748459&dopt=Abstract

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Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Author(s): Surawicz CM, Elmer GW, Speelman P, McFarland LV, Chinn J, van Belle G. Source: Gastroenterology. 1989 April; 96(4): 981-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2494098&dopt=Abstract

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Pseudomembranous colitis. Association cholestyramine. Author(s): Burbige EJ, Milligan FD.

with

antibiotics

and

therapy

with

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Source: Jama : the Journal of the American Medical Association. 1975 March 17; 231(11): 1157-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1172816&dopt=Abstract •

Reduction in the incidence of alveolar osteitis in patients treated with the SaliCept patch, containing Acemannan hydrogel. Author(s): Poor MR, Hall JE, Poor AS. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2002 April; 60(4): 374-9; Discussion 379. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11928091&dopt=Abstract

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Soy fiber delays disease onset and prolongs survival in experimental Clostridium difficile ileocecitis. Author(s): Frankel WL, Choi DM, Zhang W, Roth JA, Don SH, Afonso JJ, Lee FH, Klurfeld DM, Rombeau JL. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 1994 January-February; 18(1): 55-61. Erratum In: Jpen J Parenter Enteral Nutr 1994 March-April; 18(2): 198. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8164305&dopt=Abstract

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Suspected lamotrigine-induced toxic epidermal necrolysis. Author(s): Chaffin JJ, Davis SM. Source: The Annals of Pharmacotherapy. 1997 June; 31(6): 720-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9184711&dopt=Abstract

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The carbon dioxide requirement of Klebsiellae. Author(s): Brookes G, Barker J. Source: Journal of Medical Microbiology. 1980 February; 13(1): 31-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6767035&dopt=Abstract

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The possible role of anaerobic bacteria in chronic prostatitis. Author(s): Szoke I, Torok L, Dosa E, Nagy E, Scultety S. Source: International Journal of Andrology. 1998 June; 21(3): 163-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9669200&dopt=Abstract

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The role of ozone/oxygen in clindamycin-associated enterocolitis in the Djungarian hamster (Phodopus sungorus sungorus). Author(s): Schulz S. Source: Laboratory Animals. 1986 January; 20(1): 41-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3951192&dopt=Abstract

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Treatment and prevention of antibiotic associated diarrhea. Author(s): Bergogne-Berezin E.

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Source: International Journal of Antimicrobial Agents. 2000 December; 16(4): 521-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11118872&dopt=Abstract •

Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii. Author(s): Surawicz CM, McFarland LV, Elmer G, Chinn J. Source: The American Journal of Gastroenterology. 1989 October; 84(10): 1285-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2679049&dopt=Abstract

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Treatment outcome of nonclostridial gas gangrene at a Level 1 trauma center. Author(s): Takahira N, Shindo M, Tanaka K, Soma K, Ohwada T, Itoman M. Source: Journal of Orthopaedic Trauma. 2002 January; 16(1): 12-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11782626&dopt=Abstract

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Use of hyperbaric oxygen. Author(s): Heimbach D. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1993 August; 17(2): 239-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8399873&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMD®Health: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

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The following is a specific Web list relating to clindamycin; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Acne Vulgaris Source: Healthnotes, Inc.; www.healthnotes.com Pelvic Inflammatory Disease Source: Integrative Medicine Communications; www.drkoop.com

•

Herbs and Supplements Antibiotics Source: Healthnotes, Inc.; www.healthnotes.com Brewer's Yeast Source: Healthnotes, Inc.; www.healthnotes.com Clindamycin Oral Source: Healthnotes, Inc.; www.healthnotes.com Clindamycin Topical Source: Healthnotes, Inc.; www.healthnotes.com Probiotics Source: Healthnotes, Inc.; www.healthnotes.com Tobramycin Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. CLINICAL TRIALS AND CLINDAMYCIN Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning clindamycin.

Recent Trials on Clindamycin The following is a list of recent trials dedicated to clindamycin.8 Further information on a trial is available at the Web site indicated. •

A Phase III Comparative Study of Dapsone / Trimethoprim and Clindamycin / Primaquine Versus Sulfamethoxazole / Trimethoprim in the Treatment of Mild-toModerate PCP in Patients With AIDS Condition(s): Pneumonia, Pneumocystis carinii; HIV Infections Study Status: This study is completed. Sponsor(s): Jacobus Pharmaceutical; National Institute of Allergy and Infectious Diseases (NIAID); Glaxo Wellcome Purpose - Excerpt: To evaluate the effectiveness of two oral treatments for mild to moderate Pneumocystis carinii pneumonia (PCP): dapsone/trimethoprim or clindamycin/primaquine as compared to a standard treatment program of sulfamethoxazole/trimethoprim (SMX/TMP) to assess the tolerance of these two alternative treatments as compared to the standard treatment of SMX/TMP. Per 09/09/92 amendment, to assess the efficacy and tolerance of these two alternative treatments in patients who are intolerant to SMX/TMP. The type of treatment being studied has the advantages of wide applicability throughout the world (including developing countries) and low cost. An oral treatment is more accessible to patients than drugs given by injection or by inhalation. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below

8

These are listed at www.ClinicalTrials.gov.

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Web Site: http://clinicaltrials.gov/ct/show/NCT00000640 •

A Pilot Study of Oral Clindamycin and Pyrimethamine for the Treatment of Toxoplasmic Encephalitis in Patients With AIDS Condition(s): Toxoplasmosis, Cerebral; HIV Infections Study Status: This study is completed. Sponsor(s): Upjohn; National Institute of Allergy and Infectious Diseases (NIAID); Glaxo Wellcome Purpose - Excerpt: To collect information on the effectiveness and toxicity of clindamycin plus pyrimethamine and leucovorin calcium for the treatment of acute toxoplasmic encephalitis in adult patients with AIDS. Toxoplasmic encephalitis (encephalitis caused by Toxoplasma gondii) is the most frequent cause of focal central nervous system infection in patients with AIDS. If untreated, the encephalitis is fatal. At present, it is standard practice to give a combination of pyrimethamine and sulfadiazine to treat toxoplasmic encephalitis. The high frequency of sulfonamide-induced toxicity in AIDS patients often makes completion of a full course of therapy difficult. There is some information that high doses of parenteral (such as by injection) clindamycin used with pyrimethamine may be as effective as pyrimethamine plus sulfadiazine in the management of the acute phase of toxoplasmic encephalitis in patients with AIDS. Administration of parenteral clindamycin for prolonged periods of time, however, is costly, requires hospitalization, and is inconvenient for the patient. There is some indication that treatment of AIDS patients with acute toxoplasmic encephalitis with oral clindamycin may be effective. Leucovorin calcium is useful in preventing pyrimethamine-associated bone marrow toxicity. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000674

•

The Safety and Efficacy of Clindamycin and Primaquine in the Treatment of Mild Moderate Pneumocystis carinii Pneumonia in Patients With AIDS Condition(s): Pneumonia, Pneumocystis carinii; HIV Infections Study Status: This study is completed. Sponsor(s): National Institute of Allergy and Infectious Diseases (NIAID) Purpose - Excerpt: To determine the safety and effectiveness of clindamycin and primaquine in the treatment of mild Pneumocystis carinii pneumonia (PCP) in AIDS patients. As many as 80 percent of AIDS patients experience at least one episode of PCP and about one-third of these patients have a recurrence of the disease. Drugs currently used for treatment of acute PCP are toxic to the majority of AIDS patients. The combination of clindamycin and primaquine reduces the numbers of PCP organisms in laboratory tests and in animal studies. Both drugs can be given orally, concentrate in lung tissue, and have been used safely in humans for treatment of other diseases. It is possible that the combination may prove to be as good or better than standard therapy for PCP and side effects may be less. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000717

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Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “clindamycin” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 5. PATENTS ON CLINDAMYCIN Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “clindamycin” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on clindamycin, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Clindamycin By performing a patent search focusing on clindamycin, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on clindamycin: •

Anti-acne method and composition Inventor(s): Klein; Robert W. (Fort Washington, PA), Packman; Albert M. (Dresher, PA) Assignee(s): Dermik Laboratories, Inc. (collegeville, Pa) Patent Number: 5,767,098 Date filed: March 31, 1997 Abstract: Compositions for treating acne that contain a peroxide and an antibiotic selected from the lincomycin family are disclosed. In particular, compositions containing benzoyl peroxide and clindamycin are disclosed along with methods of treating acne using these compositions. Excerpt(s): This invention relates to a method and pharmaceutical composition useful for the topical treatment of acne. Acne is a common inflammatory disease which is very common at puberty and which occurs in skin areas where sebaceous glands are largest, most numerous, and most active. In its milder forms, acne is a superficial disorder which is evidenced by slight, spotty irritations, and which can be treated satisfactorily by ordinary skin hygiene. However, pilosebaceous follicles occurs and results in the formation of pustules, infected cysts and, in extreme cases, canalizing inflamed and infected sacs, which may become extensive and leave permanent, disfiguring scars. Therapeutic methods for treating acne include the systemic and topical administration of anti-acne agents such as antibiotics or derivatives of Vitamin A acid. In all but the severest of cases, systemic treatment of acne is not desirable because of side effects. However, systemic methods have been extensively used to treat acne because there has not been available a topical formulation which possess the level of therapeutic effectiveness desirable to relieve the unsightly symptoms of the acne disease condition. Web site: http://www.delphion.com/details?pn=US05767098__

•

Clindamycin phosphate synthesis Inventor(s): Diaz; Simon (Suffern, NY), Krishnan; Lalitha (Suffern, NY), Tobkes; Martin (Spring Valley, NY) Assignee(s): American Cyanamid Company (stamford, Ct) Patent Number: 5,182,374 Date filed: March 21, 1990 Abstract: An improved process for producing the antibiotic compound clindamycin phosphate through the use of novel intermediate, 7(S)-chloro-7-deoxylincomycin-2bis(2,2,2-trichloroethyl)phosphochloridate and similar compounds. Excerpt(s): This invention relates to an improvement in the process of producing clindamycin phosphate, an antibiotic, from clindamycin. Olindamycin is the 7-deoxy-7chloro derivative of lincomycin. Lincomycin, which is an antibiotic elaborated by an actinomycete, is a derivative of the amino acid trans-L-4-n-propylhygrinic acid, attached to a sulfur-containing derivative of an octose. Both clindamycin and lincomycin are potent antibiotics which exert their effect by binding to the 50S subunit of bacterial ribosomes thereby suppressing protein synthesis. Clindamycin has an antibacterial

Patents 79

spectrum very much like lincomycin, however it may be more potent against staphylococci and several streptococci. Clindamycin is primarily indicated for the treatment of serious intra-abdominal anaerobic infections such as those caused by bacteroides fragiles and serious respiratory infections caused by streptococci, staphylococci and pneumococci. Web site: http://www.delphion.com/details?pn=US05182374__ •

Compositions for the treatment of acne containing clindamycin and benzoyl peroxide Inventor(s): Baroody; Lloyd J. (1940 Inverness Dr., Scotch Plains, NJ 07076), Dow; Debra A. (Petaluma, CA), Dow; Gordon J. (4189 Chaparral Ct., Santa Rosa, CA 95409), Lathrop; Robert (Novato, CA) Assignee(s): Baroody; Lloyd J. (scotch Plains, Nj), Dow; Gordon J. (santa Rosa, Ca) Patent Number: 6,117,843 Date filed: May 13, 1997 Abstract: A pharmaceutical composition containing clindamycin and benzoyl peroxide is disclosed for the treatment of acne. The composition is stable for several months when stored at room temperature. Methods of preparing and of using the composition are disclosed. Excerpt(s): The present invention relates generally to compositions and methods for formulating compositions for treatment of acne. More particularly, the present invention relates to compositions comprising benzoyl peroxide and clindamycin for treatment of acne by topical administration. Acne is a common skin disorder characterized by blackheads, whiteheads, papules, pustules, cysts, and various sized nodules and scars which, in the inflammatory state of the disorder, are contaminated with bacteria such as Propionibacterium acnes. The disorder effects skin areas where the sebaceous glands are most active, and bacterial infection can occur in the sebaceous follicles. A variety of acne treatment methods have been developed, D including both systemic and topical administration of antibiotics, topical administration of organic peroxides, particularly benzoyl peroxide, and the like. Of particular interest to the present invention is the topical administration of antibiotic compositions and other active ingredients, such as benzoyl peroxide. Web site: http://www.delphion.com/details?pn=US06117843__

•

Gel-form topical antibiotic compositions Inventor(s): Fawzi; Mahdi B. (Flander, NJ), Manring; Gary L. (Oxford, OH) Assignee(s): The Procter & Gamble Company (cincinnati, Oh) Patent Number: 4,621,075 Date filed: November 28, 1984 Abstract: Topical pharmaceutical compositions, containing clindamycin phosphate, a zinc fatty acid salt, such as zinc acetate, and a non-aqueous vehicle, are disclosed. The compositions provide antibiotic performance and are present as physically stable, aesthetically-pleasing, clear, ringing gels, without requiring the use of conventional gelling agents. The method of topically treating clindamycin responsive dermatoses, such as acne, using these compositions is also disclosed.

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Excerpt(s): The present invention relates to pharmaceutical antibiotic compositions for topical administration, in the form of physically stable gels, which contain clindamycin phosphate. Antimicrobial and antibiotic agents play an important role in current medical therapy regimens. This is particularly true in dermatology where the most effective course of treatment for skin, mucous membrane or hair lesions or infections frequently includes the use of topical antibiotic agents. For example, tetracycline or clindamycin compositions, applied topically, are frequently used in the treatment of acne. The present invention encompasses topical clindamycin phosphate-containing compositions which provide effective antimicrobial performance. These compositions exist in the form of physically stable, aesthetically-pleasing, clear, ringing gels, the formation of which does not require the use of gelling agents which are generally required to form pharmaceutical gels. Clindamycin derivatives have been disclosed for use in the topical treatment of skin disorders, such as acne. U.S. Pat. No. 3,969,516, Stoughton, issued July 13, 1976, describes a method for treating acne by topically applying antibiotics of the lincomycin family, such as clindamycin phosphate. This patent does not deal with the formulation of clindamycin gels. U.S. Pat. No. 3,487,068 describes the use of clindamycin gels using conventional gelling agents. U.S. Pat. No. 3,856,943, Birkenmeyer, issued Dec. 24, 1974, describes 1'-(beta-hydroxyethyl)-1'demethylclindamycin compositions which are particularly effective in the treatment of urinary tract infections. These clindamycin analogs can be present as phosphoric acid salts and may be used together with antifungal agents, such as undecylenic acid and sodium caprylate. Web site: http://www.delphion.com/details?pn=US04621075__ •

Intravaginal clindamycin ovule composition Inventor(s): Bowman; Phil Bryan (Kalamazoo, MI), Chao; Robert Shih-Liang (Portage, MI), Pena; Lorraine Elisabeth (Kalamazoo, MI), Pesheck; Carolyn V. (Kalamazoo, MI) Assignee(s): Pharmacia & Upjohn Company (kalamazoo, Mi) Patent Number: 6,495,157 Date filed: July 20, 2000 Abstract: A highly storage-stable composition for vaginal administration of clindamycin is disclosed which is useful for the treatment of bacterial vaginosis. The composition is a vaginal suppository containing an antimicrobially effective amount of clindamycin dispersed in a Hard Fat NF suppository base. Hard Fat NF suppository bases provide a clindamycin product having long term storage stability while providing efficacy against bacterial vaginosis which is equivalent to clindamycin vaginal creams. Excerpt(s): The present invention is directed to a treatment for bacterial vaginosis (BV). The exact etiology of BV is unclear although it appears to result from an overgrowth of organisms in the vaginal flora. Although generally a mild condition, BV is distressing to the patient because of the unpleasant vaginal odor and discharge. In addition, it is epidemiologically linked to several urogenital diseases. Clindamycin vaginal cream (CVC) 100 mg per day for 7 days is a standard treatment for BV. It has recently been demonstrated that a 3-day treatment course of CVC is as effective as a 7-day course. However, even with a 3-day treatment, the use of creams is considered to be inconvenient. A vaginal ovule (suppository) formulation containing clindamycin would offer patients an alternative, more convenient dosage form. Therefore, the development of a vaginal suppository having at least the same efficacy as CVC was undertaken. As a result of this development effort, it was discovered that Hard Fat NF suppository bases

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significantly increased the storage stability of clindamycin. We have developed a highly storage-stable composition for vaginal administration of clindamycin which comprises a vaginal suppository containing an antimicrobially effective amount of clindamycin dispersed in a Hard Fat suppository base, preferably Hard Hat NF grade. Hard Fat bases are a mixture of glyceride esters of higher saturated fatty acids. The Hard Fat NF suppository bases provide a clindamycin product having increased stability over the CVC formulation while providing equivalent efficacy against BV. The present invention comprises a composition for intravaginal administration of clindamycin which composition contains an antimicrobially effective amount of clindamycin dispersed in a Hard Fat NF base. Hard Fat is defined in the National Formulary as "a mixture of glycerides of saturated fatty acids." It was surprisingly found that clindamycin is extremely storage stable in a Hard Fat NF base. Web site: http://www.delphion.com/details?pn=US06495157__ •

Lincomycin compounds Inventor(s): Birkenmeyer; Robert D. (Comstock Township, Kalamazoo County, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,278,789 Date filed: May 19, 1980 Abstract: Novel useful analogs of the well known antibiotics lincomycin and clindamycin. These analogs are prepared by condensing a cyclic acid with a sugar amine. Excerpt(s): The characteristics and preparation of the antibiotic lincomycin are disclosed in U.S. Pat. No. 3,086,912. Clindamycin is disclosed i U.S. Pat. No. 3,496,163. These antibiotics have been extensively used as medicines in humans and animals. A number of patents world-wide have issued concerning these antibiotics and a variety of derivatives thereof. Further, this application relates to novel 2-phosphates and 2palmitates wherein the substitution is attached to the oxygen atom at the 2-position of the sugar ring of the above compounds. When a pyridine acyl group is used, the resulting analog can be reduced to give a mixture of the corresponding saturated compounds, one of which is the L-cis isomer. Other compounds which may be present include the L-trans, D-cis, and D-trans isomers. Generally, for any of the compounds described herein, the reduced form is more antibacterially-active than the unsaturated precursor. The use of a piperidine acyl group gives analogs existing as D-cis, L-cis, Dtrans, and L-trans isomers. Again, the L-cis isomer has been found to be more antibacterially active. Web site: http://www.delphion.com/details?pn=US04278789__

•

Lincomycin nucleotides Inventor(s): Argoudelis; Alexander D. (Portage, MI), Stroman; David W. (Portage, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,383,109 Date filed: April 20, 1981

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Abstract: Novel and useful ribonucleotides of analogs of the well known antibiotics lincomycin and clindamycin. These ribonucleotides are unexpectedly highly active against Streptococcus hemolyticus and Staphylococcus aureus in vivo. Excerpt(s): The characteristics and preparation of the antibiotic lincomycin are disclosed in U.S. Pat. No. 3,086,912. Clindamycin is disclosed in U.S. Pat. No. 3,496,163. These antibiotics have been extensively used as medicines in humans and animals. A number of patents world-wide have issued concerning these antibiotics and a variety of derivatives thereof. The structural formulas for lincomycin (1) and clindamycin (2) are shown in Chart 1. Linomycin and clindamycin 3-nucleotides are disclosed and claimed in U.S. Pat. No. 3,671,647. All of the lincomycin and clindamycin compounds disclosed in U.S. Pat. No. 3,671,647 have the propyl hygric acid moiety. These 3-nucleotides were found by test against S. aureus in vivo to have an activity approximately one-tenth of the parent compound. Web site: http://www.delphion.com/details?pn=US04383109__ •

Method for detecting bacteria in urine and for treating rheumatoid arthritis, essential hypertension and other diseases associated with bacteriuria Inventor(s): Hyman; Edward S. (3420 Jefferson Ave., New Orleans, LA 70125) Assignee(s): None Reported Patent Number: 4,673,637 Date filed: April 23, 1984 Abstract: A novel method of urine specimen preparation comprising intense centrifugation and a lipid wash mitigates or prevents loss of bacteria-containing sediment prior to examination. Modifications of the method facilitate examination of urines with interfering constituents such as glucose, phosphates, and soluble and insoluble proteins. By this method, bacteria have been found in the urine of patients suffering from rheumatoid arthritis and essential hypertension. These bacteria were not detected in standard urine preparations. Administration of antibiotic agents effective against the bacteria detected, such as clindamycin, destroyed these bacteria and provided therapeutic relief. Excerpt(s): This invention relates to a new method of detecting abnormal levels of bacteria in urine, and to new methods for the treatment of patients suffering from rheumatoid arthritis, essential hypertension, and other diseases in which significant bacteriuria was detected by the novel specimen preparation of the present invention that would not have been easily demonstrated by known procedures. The direct microscopy and the culture methods each have pitfalls In the past 20-25 years the direct visualization of bacteria in urine has largely been abandoned in favor of the methods involving culturing and counting the colonies of bacteria. Indeed virtually all of the studies of the significance of bacteriuria are based upon culturing the urine, and the direct microscopic examination of urine has been relegated to the status of a quick but inadequate screening procedure which may be helpful because it can be correlated with the culture methods. Rheumatoid arthritis (RA) is a chronic inflammation of the joints, generally regarded as a systemic autoimmune disorder. Its etiology is unknown, but it has been postulated that it is associated with microbial infection. See, e.g., D. C. Demonde, ed., Infection and Immunity in the Rheumatic Diseases, 95-287 (Blackwell Scientific Publications, London: 1976). The evidence, however, until the present discovery, was inconclusive. See, e.g., D. J. McCarty, et al., ed., Arthritis and Allied

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Conditions: A Textbook of Rheumatology, ch 28 at 417 (9th ed. 1979); R. G. Petersdorf, et al., ed., Harrison's Principles of Internal Medicine, Part Six, Chapter 346, at 1977 (McGraw Hill: 1983). Bacteriuria has not been associated with RA, and indeed one authority remarks "Urinary abnormalities are relatively uncommon in RA. Urinary tract infection was not found to be increased in RA patients." McCarty, supra, chapter 33, page 499, citing Ann. Rheum. Dis., 27: 345 (1968). Hypertension is a chronic elevation of blood pressure resulting from the obstruction of blood flow within the kidney (secondary hypertension) or without apparent cause (essential hypertension). One kidney disorder associated with secondary hypertension is pyelonephritis, the inflammation of the renal pelvis of the kidney as a result of bacterial infection, usually responsive to antibiotics. It has not been reported, however, that there is any correlation between essential hypertension and asymptomatic bacteriuria (bacteriuria observed in patients not reporting symptoms of urinary tract disorders). According to N. M. Kaplan, Clinical Hypertension, 14 (3d. ed. 1982), bacteriuria is found in 2-5% of hypertensives. Most of these positive cultures were of gram-negative rods. The method of the present invention has demonstrated a much higher incidence of bacteriuria in hypertensives, perhaps as high as 90%, and that cocci or "exploded cocci" are found in considerable numbers. Web site: http://www.delphion.com/details?pn=US04673637__ •

Method for treating pneumocystis carinii pneumonia patients with clindamycin and primaquine Inventor(s): Bartlett; Marilyn S. (Indianapolis, IN), Queener; Sherry F. (Indianapolis, IN), Smith; James W. (Indianapolis, IN) Assignee(s): Indiana University Foundation (bloomington, In) Patent Number: 4,835,140 Date filed: August 20, 1987 Abstract: The combination of clindamycin and primaquine or pharmaceutical salts thereof is effective in treating patients with Pneumocystis carinii pneumonia. Excerpt(s): This invention is a novel treatment of patients having Pneumocystis carinii pneumonia. Clindamycin and primaquine are drugs that have been used extensively in humans. Clindamycin is an lincosamide antibiotic active against a variety of bacteria including aerobic gram positive cocci, anaerobic gram negative bacilli, anaerobic gram positive nonspore-forming bacilli, and anaerobic and microaerophilic cocci. The preparation of clindamycin is given by Magerlein, et al., in Anti-microbial Agents and Chemotherapy, 727 (1966). Clindamycin also has activity against malarial parasites although the exact effect on plasmodia is not known. The drug is rapidly and virtually completely absorbed after oral dosage and distributes well into body fluids and tissues. Primaquine is a potent anti-malarial agent now used mainly for radical cure of vivax malaria. The preparation of primaquine is given by Elderfield, et al., in Journal of the American Chemical Society, 4816 (1955). The drug is rapidly absorbed after oral dosage and has extensive tissue distribution. An estimated one to one and one-half million people in the United States are infected with a human retrovirus, the human immunodeficiency virus type I, HIV-1, which is the etiological agent of acquired immunodeficiency syndrome, AIDS, Norman, C., Science, 661-662 (1986). Of those infected, an estimated two hundred and fifty thousands people will develop AIDS in the next five years, Curran, J.W., et al., Science, 1352-1357 (1985). Pneumocystis carinii pneumonia is the most common life threatening infection in patients with aids. The

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infection occurs at least once in as many as eighty percent of AIDS patients and about one third of the total number of episodes of pneumocystis carinii pneumonia are fatal. Fewer than one half of the AIDS patients treated with conventional drugs, either trimethoprim/sulfamethoxazole or pentamidine, are able to complete a full course of therapy because a majority of these patients develop one or more serious adverse reactions such as severe rash, neutropenia, thrombocytopenia, anemia, liver disfunction, renal failure or disturbances in serum glucose, calcium or sodium levels. Web site: http://www.delphion.com/details?pn=US04835140__ •

Method of treating cardiac arrhythmia Inventor(s): Allen; Harry R. (Texas Township, Kalamazoo County, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,393,054 Date filed: May 19, 1982 Abstract: The 3-(5'-adenylate) of lincomycin- and clindamycin-type compounds in which the propyl hygric acid moiety has been replaced by different cyclic amino acids can be used to treat cardiac arrhythmia in humans and animals. Excerpt(s): The characteristics and preparation of the antibiotic lincomycin are disclosed in U.S. Pat. No. 3,086,912. Clindamycin is disclosed in U.S. Pat. No. 3,496,163. These antibiotics have been extensively used as medicines in humans and animals. A number of patents world-wide have issued concerning these antibiotics and a variety of derivatives thereof. The structural formulas for lincomycin (1) and clindamycin (2) are shown in Chart 1. The lincomycin- and clindamycin-type compounds which can be converted to the 3-(5'-adenylate) are shown in Chart 2. In place of the hydroxyl at the three position of the lincosaminide moiety, there is substituted the adenylate residue. Web site: http://www.delphion.com/details?pn=US04393054__

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Method of treating malaria Inventor(s): Birkenmeyer; Robert D. (Comstock Township, Kalamazoo County, MI), Lewis; Charles (Kalamazoo Township, Kalamozoo County, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,293,547 Date filed: August 25, 1980 Abstract: A process for treating a protozoan disease, for example, malaria, by the systemic administration to a subject hosting a malarial parasite of a novel analog of the well-known antibiotics lincomycin and clindamycin. These analogs are prepared by condensing a cyclic acid with a sugar amine. Excerpt(s): Further, this application relates to the use of novel 2-phosphates and 2palmitates wherein the substitution is attached to the oxygen atom and at the 2 position of the sugar ring of the above compounds. It has been found in accordance with the present invention that the systemic administration of a compound of the above formulas to a subject hosting a protozoan parasite provides effective suppressive treatment of the disease. For example, when the protozoan is a malarial parasite, the subject can be

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animal, e.g., mice infected with P. berghei; birds, e.g. ducks infected with P. lophurae and chicks infected with P. gallinaceum, and mammals such as primates, e.g., monkeys infected with P. cynomolqi, and humans infected with P. falciparum, P. vivax, and P. malariae. The compounds of the formulas can be administered systemically by the oral and parenteral routes preferably in association with a pharmaceutical carrier or in the case of animals (orally) in association with the animals feed. Additionally, the compounds of the formulas can be mixed with table salt for administration to humans for use in a program of mass drug administration in developing countries. Web site: http://www.delphion.com/details?pn=US04293547__ •

Method of treating skin and composition Inventor(s): Tomas; Robert E. (29926 S. Stockton, Farmington Hills, MI 48336) Assignee(s): None Reported Patent Number: 5,674,539 Date filed: May 18, 1995 Abstract: A topical medication for the treatment of skin pathology including acne is comprised of tetracycline, minocycline, clindamycin, erythromycin, or doxicycline and selenium sulfide or sulfur in a pharmaceutically acceptable carrier. The lotion, cream or ointment is applied to the lesions, left in place briefly and washed off. This is repeated twice daily. The lesions generally clear up within a week. Because the treatment is local, the serious side effects of systemic administration of drugs is avoided. Excerpt(s): This invention relates to the use of tetracycline in combination with sulfur or selenium sulfide in topical preparations for the treatment of acne. The treatment of acne vulgaris has been directed primarily to cleansing the skin, avoidance of certain foods and chocolate and the topical application of various astringents and ointments. Certain chemicals have been tried with variable success including peroxides topically applied. A theory has developed that a causative factor may be the formation of free fatty acids in the sebaceous glands or ducts. U.S. Pat. No. 4,005,198 issued Jan. 25, 1977 to Skillern discloses the use of the specific duiretic Methyclothiazide orally in conjunction with oral tetracycline to control acne with the tetracycline discontinued after some reduction in symptoms. The antibiotic is used in this case for its purported action in reducing the formation of free fatty acids in the sebaceous ducts and not for its antibiotic activity. Web site: http://www.delphion.com/details?pn=US05674539__

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Pharmaceutical composition Inventor(s): Freudensprung; Brigitte (Holzkirchen, DE), Vulpescu; Dan-Gabriel (Bremerhaven, DE) Assignee(s): Hexal AG (holzkirchen, De) Patent Number: 6,537,970 Date filed: February 25, 2000 Abstract: The invention relates to a novel pharmaceutical combination comprising clindamycin and clotrimazole for use for vaginal infections.

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Excerpt(s): This is a National Stage Application based on PCT/EP98/05454 filed Aug. 27, 1998 designating the Uinted States of America. The present invention is in a novel pharmaceutical composition comprising a combination of clindamycin and clotrimazole for vaginal use for bacterial infections, fungal infections or mixed infections of the vagina. Conventional therapies for the treatment of bacterial infections of the vagina, such as, for example, bacterial vaginosis, which are caused by the interaction of Gardnerella vaginalis and anaerobic bacteria, feature treatments with chemotherapeutics acting on anaerobes and protozoa, such as, for example, metronidazole or tinidazole, or the treatment with an antibiotic, such as amoxicillin or clindamycin. Treatment is carried out either orally or by topical vaginal application. Web site: http://www.delphion.com/details?pn=US06537970__ •

Process for the preparation of clindamycin phosphate Inventor(s): Lee; Ying-Chi (Libertyville, IL), Matier; William L. (Hockessin, DE), Woo; Chi (Libertyville, IL) Assignee(s): E. I. DU Pont DE Nemours and Company (wilmington, De) Patent Number: 4,895,934 Date filed: March 27, 1989 Abstract: A method for the preparation of clindamycin phosphate by first preparing the novel intermediate, clindamycin phosphoryl benzylate. The method can be used to make other, structurally related compounds. Excerpt(s): Clindamycin, 7(S)-chloro-7-deoxylincomycin, the preparation of which is described in U.S. Pat. No. 3,487,068 issued Dec. 30, 1969, is a potent antibacterial agent. Clindamycin is a derivative of the amino acid trans-L-4-n-propylhygrinic acid, attached to a sulfur-containing derivative of an octose. Clindamycin and lincomycin bind exclusively to the 50 S subunit of bacterial ribosomes and suppress protein synthesis. Although clindamycin, erythromycin and chloramphenicol are not structurally related, they all act at this site, and the binding of one of these antibiotics to the ribosome may inhibit the reaction of the other. In general, clindamycin is similar to erythromycin in its activity in vitro against pneumococci, Strep. pyogenes, and viridans streptococci. Almost all such bacterial strains are inhibited by concentrations of 0.04.mu.g/mL. It is also active against many strains of Staph. aureus but may not inhibit methicillinresistant strains. Clindamycin is nearly completely absorbed following oral administration, and peak plasma concentrations of 2 to 3.mu.g/mL are attained within 1 hour after the ingestion of 50 mg. The presence of food in the stomach does not reduce absorption significantly. The half-life of the antibiotic is about 2.5 hours, and modest accumulation of drug is to be expected if it is given at 6 hour intervals. The phosphate ester of clindamycin which is given parenterally, is also rapidly hydrolyzed in vivo to the active parent compound. Following intramuscular injection, peak concentrations in plasma are not attained for 3 hours in adults and 1 hour in children. The recommended parenteral dosages provide peak plasma concentrations of 5 to 15.mu.g/mL and effective antimicrobial activity for approximately 8 hours. Most of the drug is inactivated by metabolism to N-demethylclindamycin and clindamycin sulfoxide, which are excreted in the urine and bile. The half-life of clindamycin is lengthened only slightly in patients with markedly impaired renal function, and little adjustment of dosage is required for such individuals. In accordance with one embodiment of the present invention, clindamycin phosphate is prepared by first preparing the novel clindamycin phosphoryl benzylate. Preparation of clindamycin phosphate by means of

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this intermediate, which can be easily isolated and purified, eliminates the need for use of column chromatography. For example, see U.S. Pat. No. 3,487,068 issued Dec. 30, 1969, particularly Examples 1 and 2 wherein lincomycin-2-phosphate and 7(S)-chloro-7deoxylincomycin-2-phosphate are purified by column chromatography. In a specific embodiment of the invention, this monophosphate benzyl ester is prepared by treating protected clindamycin hydrochloride with phosphorus oxychloride in the presence of a suitable solvent to obtain a reaction mixture, adding benzyl alcohol to the reaction mixture and subsequently adding water to complete the reaction. In this reaction, the benzyl alcohol is not only a reactant but also a powerful solvent in which the desirable intermediate is freely soluble. Moreover, any by-products are easily removed by washing with an aqueous solution. Web site: http://www.delphion.com/details?pn=US04895934__ •

Protracted-release adminstration forms containing clindamycin palmitate Inventor(s): Cimbollek; Monika (Mannheim, DE), Nies; Berthold (Fr ankisch-Crumbach, DE) Assignee(s): Merck Patent Gesellschaft Mit Beschrankter Haftung (darmstadt, De) Patent Number: 5,607,685 Date filed: February 8, 1995 Abstract: The invention relates to the use of clindamycin palmitate for the production of pharmaceutical administration forms having a protracted release of the antibiotic active compound clindamycin, and corresponding administration forms which are preferably used in the form of shaped implants. Excerpt(s): The invention relates to the use of clindamycin palmitate for the production of pharmaceutical administration forms having a protracted release of the antibiotic active compound clindamycin and to corresponding administration forms, in particular in the form of shaped implants. Clindamycin is an antibiotic of generally recognized value. It exhibits particular effectiveness against Gram-positive organisms such as staphylococci and streptococci and also against Gram-negative anaerobes. This antibiotic is therefore used for the treatment of a wide spectrum of diseases, e.g., in the control of infections of the digestive tract, the skin and the soft tissue and also in osteomyelitis and in gynecological infections. Clindamycin has furthermore been successfully employed in prophylaxis and therapy of bacterial endocarditis. In the indications mentioned, this antibiotic is used in the form of physiologically acceptable salts such as, for example, clindamycin HCl, clindamycin phosphate ester or alternatively in the form of free clindamycin base. Web site: http://www.delphion.com/details?pn=US05607685__

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Thesis of 7-halo-7-deoxylincomycins Inventor(s): Livingston; Douglas A. (Kalamazoo, MI), Petre; Janet E. (Portage, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,710,565 Date filed: January 24, 1986

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Abstract: Process for preparing clindamycin and analogs thereof by reacting lincomycin or an analog thereof with a dimethylformamide and an excess of thionyl halide. Excerpt(s): The present invention is an improved process for preparing 7-halo-7deoxylincomycins, including clindamycin, and pharmaceutically acceptable forms thereof from lincomycin and analogs thereof. Clindamycin is a well known antibiotic that has pharmacologically useful properties. Processes for preparing 7-halo-7deoxylincomycins are known. U.S. Pat. Nos. 3,435,025, 3,496,163 and 3,509,127 disclose a process in which the 7-hydroxyl group of lincomycin and analogous compounds are replaced with a halogen group by reacting said compounds with a Rydon reagent and heating the resulting product. The use of thionyl chloride to convert lincomycin and analogous compounds to 7-chloro-7-deoxy compounds is described in U.S. Pat. Nos. 3,496,163, 3,509,127 and 3,574,186. The temperature needed to effect the transition described in these patents in neutral solvents, are well above room temperature. In this regard, all of the examples disclose the reaction being conducted by refluxing in carbon tetrachloride (about 77.degree. C.). A process for preparing 7-halo-7-deoxylincomycin by the use of a sulfite-protected lincomycin and Rydon reagents is described in U.S. Pat. No. 3,714,141. Web site: http://www.delphion.com/details?pn=US04710565__ •

Topical clindamycin preparations Inventor(s): Ayer; Donald E. (Kalamazoo, MI), Flynn; Gordon L. (Ann Arbor, MI), Schlagel; Carl A. (Kalamazoo, MI) Assignee(s): The Upjohn Company (kalamazoo, Mi) Patent Number: 4,018,918 Date filed: March 19, 1976 Abstract: Disclosed is an anti-inflammatory compound, 6.alpha.,9.alpha.-di-fluoro11.beta.,17.alpha.,21-trihydroxy-16.beta.-meth ylpregna-1,4-diene-3,20-dione 17,21diacetate, and topical pharmaceutical formulations which include antimicrobial agents. Excerpt(s): The compound, 6.alpha., 9.alpha.-difluoro-11.beta., 17.alpha., 21-trihydroxy16.beta.-methylpregna-1,4-diene-3,20-dione (10) and the 21-acetate are disclosed in U.S. Pat. No. 3,557,158 and are described as possessing anti-inflammatory properties. A variety of steroid compounds have found use as local or topical anti-inflammatory agents. These are usefully administered to man and animals in convenient pharmaceutical forms such as creams, lotions, ointments, solutions, suspensions, drops, aerosols, dusting powders, suppositories and the like and cause reduction of the inflammatory process in situ for example in skin disorders, being used to control corticosteroid-responsive dermatoses such as psoriasis, eczema, seborrheic dermatitis, allergic contact dermatitis, providing symptomatic relief. Clindamycin is known, and has been disclosed for topical use with anti-inflammatory steroids, but not with the antiinflammatory steroid of the present disclosure. See U.S. Pat. Nos. 3,509,257; 3,155,580; and 3,539,689. Web site: http://www.delphion.com/details?pn=US04018918__

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Topical compositions containing bensoyl peroxide and clindamycin and method of use thereof Inventor(s): Popp; Karl F. (Schodack Landing, NY), Stiefel; Werner K. (Coral Gables, FL) Assignee(s): Stiefel Laboratories, Inc. (coral Gables, Fl) Patent Number: 5,466,446 Date filed: February 16, 1994 Abstract: Dermatological conditions are treated by topically applying to the affected area an effective amount of a combination benzoyl peroxide and clindamycin composition. Excerpt(s): The present invention pertains to topical preparations comprising benzoyl peroxide and clindamycin, which are used for treating skin disorders involving the sebaceous glands and follicles in humans. Skin disorders involving the sebaceous glands and follicles in humans include conditions such as acne and rosacea, as well as other noninfectious dermatological diseases involving microorganisms. Such disorders are often marked by inflammation. In the past, these dermatological disorders have been treated with oral and/or topical antibacterial agents. The oral antibiotics used include tetracycline, erythromycin and minocycline. The topical compositions used have separately contained the antibiotics tetracycline, erythromycin and clindamycin, as well as benzoyl peroxide, which exerts its antibacterial action via its potent oxidizing properties. However, it is the strong oxidizing properties of peroxide that results in unstable compositions. Benzoyl peroxide also can act as a sebosuppressant, an irritant, and comedolytic agent. Web site: http://www.delphion.com/details?pn=US05466446__

Patent Applications on Clindamycin As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to clindamycin: •

Composition and method for dermatological treatment Inventor(s): Patel, Pravin M.; (Bloomfield Hills, MI) Correspondence: Gifford, Krass, Groh, Sprinkle; Anderson & Citkowski, PC; 280 N Old Woodard Ave; Suite 400; Birmingham; MI; 48009; US Patent Application Number: 20030215493 Date filed: April 30, 2003 Abstract: A topical composition for the treatment of acne and other dermatological conditions comprises a liposomal formulation of a retinoid and an antibiotic in which the retinoid is disposed in the lipid phase of the formulation, and the antibiotic is disposed in the aqueous phase. Lincosamides, such as clindamycin, are one group of antibiotics which may be used in the composition. Tretinoin is one preferred retinoid.

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This has been a common practice outside the United States prior to December 2000.

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Also disclosed are methods for making the compositions and methods for using the composition. Excerpt(s): This patent application claims priority of U.S. Provisional Patent Application Serial No. 60/377,002 filed Apr. 30, 2002, entitled "Composition and Method for Dermatological Treatment". This invention relates generally to the treatment of skin conditions such as acne. More specifically, the invention relates to dermatological compositions based upon liposomal formulations of retinoids and antibiotics, and their use for the treatment of acne. Acne is a dermatological disorder which occurs when inflamed sebaceous glands become blocked with sebum, skin cells and bacteria. Lesions occur in more superficial forms as open or closed comedones, as well as in deeper varieties such as nodules and cysts. Acne tends to appear at the onset of puberty and persists into early adulthood. One reason for the association of acne with puberty is that sebum levels are under hormonal control. While not usually physically disabling, acne can be particularly disturbing for cosmetic reasons to those affected. In addition, untreated or inappropriately treated acne can result in permanent, disfiguring scarring. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Composition and method for rectal delivery of a lincosamide antibiotic drug Inventor(s): Bowman, Phil B.; (Kalamazoo, MI), Chao, Robert S.; (Portage, MI), Jacobsen, Clayton W.; (Plainwell, MI), Pena, Lorraine E.; (Kalamazoo, MI), Pesheck, Carolyn V.; (Kalamazoo, MI) Correspondence: Pharmacia & Upjohn Company; Patent Department; 800 N. Lindbergh Boulevard - 04e; ST. Louis; MO; 63167; US Patent Application Number: 20020197320 Date filed: February 5, 2002 Abstract: A suppository composition and method for rectal administration of a lincosamide antibacterial drug, such as clindamycin, lincomycin, or pirlimycin, is disclosed. The composition is a rectal suppository containing an antimicrobially effective amount of the lincosamide in particulate form dispersed in a Hard Fat suppository base, preferably a Hard Fat NF suppository base. The most preferred suppository compositions of the present invention have long term storage stability, while maintaining effectiveness against bacterial infections. Excerpt(s): The present patent application is a continuation-in-part of U.S. patent application Ser. No. 09/619,930, filed Jul. 20, 2000, that claims the benefit of U.S. Provisional Patent Application Serial No: 60/147,561, filed Aug. 6, 1999. The present invention relates to a pharmaceutical composition useful for rectal application for treatment or prevention of infective disease. In particular, the present invention relates to a rectal formulation of a lincosamide antibacterial drug that can be used for treatment or prevention of infection by a gram-positive bacterial agent. The field of the present invention also includes therapeutic or prophylactic use of such a formulation, and use of such a formulation in preparation of a medicament. Lincosamide compounds have been reported having therapeutically and/or prophylactically useful antibiotic, in particular antibacterial, effect. Lincosamides, such as clindamycin, lincomycin, and pirlimycin, have long been recognized as antibiotics active against bacteria, primarily, against grampositive bacteria. Lincosamides are known to prevent translocation of nascent polypeptide, making the class of compounds useful for the treatment of a variety of disorders related to bacterial infections.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Crystaline clindamycin free base Inventor(s): Chao, Robert S.; (Portage, MI), Hawley, Michael; (Kalamazoo, MI), Jones, Donald P.; (Portage, MI), Reeder, Lisa M.; (Kalamazoo, MI) Correspondence: Pharmacia Corporation; Global Patent Department; Post Office Box 1027; ST. Louis; MO; 63006; US Patent Application Number: 20030073648 Date filed: August 26, 2002 Abstract: The antibiotic drug clindamycin is provided as a crystalline free base. Three polymorphic/pseudopolymorphic forms of crystalline clindamycin free base are disclosed. Also provided are pharmaceutical compositions comprising crystalline clindamycin free base. Processes for preparing crystalline clindamycin free base and compositions thereof are also provided along with methods for treating medical conditions with the pharmaceutical compositions. Excerpt(s): This application claims the benefit of U.S. provisional application serial No. 60/315,375, filed Aug. 28, 2001, and U.S. provisional application serial No. 60/377,892, filed May 1, 2002. This invention relates to the free base of the antibiotic drug clindamycin and, more particularly, to crystalline clindamycin free base and different crystalline forms thereof. The invention also relates to methods of producing such material, and to methods of using such material in pharmaceutical compositions for the treatment and prevention of bacterial infections. Clindamycin is an antibiotic used to treat a wide variety of bacterial infections. The compound is also known as 7(S)-chloro7-deoxylincomycin, methyl 7-chloro-6,7,8-trideoxy-6-(1-methyl- -trans4-propyl-L-2pyrrolidinecarboxamido)-1-thio-L-threo-.alpha.-D-galact- o-octo-pyranoside or methyl 7-chloro-6,7,8-trideoxy-6-[[(1-methyl-4-propyl- -2-pyrrolidinyl)carbonyl]amino]-1-thioL-threo-.alpha.-D-galacto-octo-pyra- noside. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Multiple pulse extended release formulations of clindamycin Inventor(s): Cox, Steven R.; (Schoolcraft, MI), Ganorkar, Loksidh D.; (Kalamazoo, MI), Heimlich, John M.; (Portage, MI), Lee, Ernest J.; (Kalamazoo, MI), Noack, Robert M.; (Grand Rapids, MI), VerHage, Ronald R.; (Lawton, MI) Correspondence: Pharmacia Corporation; Global Patent Department; Post Office Box 1027; ST. Louis; MO; 63006; US Patent Application Number: 20030129236 Date filed: December 19, 2002 Abstract: The present invention is directed to an oral dosage form for multiple-pulsed delivery of at least two fractions of clindamycin to a subject, one in an immediaterelease form and the other in an extended release form. The oral dosage forms of the present invention provide a means for treating or preventing gram-positive bacterial infections with a minimal number of treatments per day, potentially, as little as once or twice per day.

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Excerpt(s): This application claims the benefit of U.S. Provisional Application Serial No. 06/342,642, filed Dec. 20, 2001. The present invention relates to orally deliverable pharmaceutical compositions of antibiotics, such as clindamycin, to processes for preparing such compositions, and to methods of treatment of disorders caused by bacteria by orally administering such compositions to a subject. In one aspect, the present invention relates to orally deliverable pharmaceutical compositions designed to release clindamycin in the colon of a subject. Clindamycin has long been recognized as a broad spectrum antibiotic, useful for the treatment of a variety of disorders related to bacterial infections. Oral immediate release formulations of clindamycin have been developed, designed to release clindamycin in a single pulse into the upper gastrointestinal ("GI") tract. (See, e.g. commercial oral formulations of clindamycin hydrochloride designed for adults, such as CLEOCIN.RTM. HCl from Pharmacia Corporation; and oral formulations of clindamycin palmitate hydrochloride designed for children, such as CLEOCIN.RTM. PEDIATRIC). Both clindamycin hydrochloride and clindamycin palmitate hydrochloride are hydrolyzed to clindamycin free base in the gastrointestinal tract of a subject, prior to being absorbed into the bloodstream. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with clindamycin, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “clindamycin” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on clindamycin. You can also use this procedure to view pending patent applications concerning clindamycin. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON CLINDAMYCIN Overview This chapter provides bibliographic book references relating to clindamycin. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on clindamycin include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “clindamycin” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on clindamycin: •

Pneumocystis Carinii Pneumonia Contact: Marcel Dekker, Incorporated, 270 Madison Ave, New York, NY, 10016, (800) 228-1160. Summary: This book presents a comprehensive examination of all aspects of Pneumocystis carinii pneumonia (PCP). This form of pneumonia is prevalent among people with AIDS and other immunosuppressed patients. The author has included a review of recent advances in basic biology, epidemiology, pathophysiology, clinical features, diagnosis, treatment, and prevention of this opportunistic infection. The book contains a treatment section detailing important topics in drug development and includes discussions of pentamidine; folate antagonists; primaquine, other 8aminoquinolines, and clindamycin; hydroxynapthoquinones, glucan synthetase inhibitors, and corticosteroids.

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Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “clindamycin” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “clindamycin” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “clindamycin” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Clindamycin and modulation of host defence : proceedings of a symposium, Madrid, Spain, April 13-14, 1985; ISBN: 9021915375; http://www.amazon.com/exec/obidos/ASIN/9021915375/icongroupinterna

Chapters on Clindamycin In order to find chapters that specifically relate to clindamycin, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and clindamycin using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “clindamycin” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on clindamycin: •

Antibiotics for Oral and Maxillofacial Infections Source: in Newman, M.G. and van Winkelhoff, A.J., eds. Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 157-173. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $32.00 plus shipping and handling. ISBN: 0867153970. Summary: Infections of the oral and maxillofacial region, although commonly encountered by dentists, can be challenging to manage. This chapter on antibiotics for the treatment of oral and maxillofacial infections is from a textbook that integrates basic facts and principles of antibiotic therapy with recently-emerged concepts of care. The author presents guidelines for using a combination of antibiotics and surgery to manage minor orofacial and odontogenic (arising from the tissues that produce teeth) infections in the office setting. Topics include the microbiology of odontogenic infections; the natural course of odontogenic infections, i.e., cellulitis, abscess, and sinus tract; the spread of infection; the role of depressed host defenses, due to chemotherapy, metabolic diseases, organ transplants, or myeloproliferative diseases; and the use of dental spectrum antibiotics, including penicillin, extended spectrum penicillins, cephalosporins, erythromycin, clarithromycin, clindamycin, tetracycline, metronidazole, and fluoroquinolones. The author also reviews the principles of therapy,

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including determination of severity of the infection, evaluation of host defenses, surgical treatment, antibiotic choice, antibiotic administration, follow up, and side effects and secondary infection. The chapter concludes with a discussion of wound infection prophylaxis and special considerations, including sinus perforations, avulsed teeth, osteomyelitis, dry socket (alveolar osteitis), pericoronitis, routine extractions, and impacted third molars (wisdom teeth). Important principles, key facts, and clinical insights are highlighted and the chapter concludes with a list of references. 3 figures. 4 tables. 7 references. •

Considerations for Female Patients Source: in Newman, M.G. and van Winkelhoff, A.J., eds. Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 235-242. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $32.00 plus shipping and handling. ISBN: 0867153970. Summary: This chapter discusses side effects and risks associated with the use of antibiotics and antimicrobials in women, with an emphasis on the effects of such treatment on pregnant and lactating women. The chapter is from a textbook that integrates basic facts and principles of antibiotic therapy with recently-emerged concepts of care. The author discusses considerations for antibiotic prescriptions, including vaginitis (a common side effect), and contraceptive failure; antibiotics that cross the placenta and reach the fetus; specific antibiotics and their effects in pregnant and lactating women, including penicillins, tetracycline, cephalosporins, erythromycin, clindamycin, metronidazole, azithromycin, aminoglycosides, sulfonamides, and chloramphenicol; periodontal considerations; and a final note on oral pain medications for pregnant or lactating women who are undergoing dental treatment. Important principles, key facts, and clinical insights are highlighted and the chapter concludes with a list of references. 1 figure. 2 tables. 33 references.

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Antibiotics in Periodontal Therapy Source: in Newman, M.G. and van Winkelhoff, A.J., eds. Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 113-126. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $32.00 plus shipping and handling. ISBN: 0867153970. Summary: This chapter on antibiotics for the treatment of periodontal disease is from a textbook that integrates basic facts and principles of antibiotic therapy with recentlyemerged concepts of care. The authors note that in general, antibiotics are seldom necessary for treatment of gingivitis (gum inflammation) and chronic periodontal diseases. Scaling, root planing, and periodontal surgery (if indicated) are anti-infective measures that may negate the need for antibiotics. The authors discuss conditions that may call for systemic antimicrobial periodontal therapy, the infecting microorganisms, and the use of antibiotics in situations of plaque formation and gingivitis and periodontitis, and the selection of antibiotic regimens in periodontal therapy (single drug regimens, combination antimicrobial therapy, and sequential regimens). Specific

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drugs covered are penicillins, tetracyclines, minocycline, doxycycline, metronidazole, clindamycin, ciprofloxin, spiramycin, and amoxicillin and clavulanic acid. Important principles, key facts, and clinical insights are highlighted and the chapter concludes with a list of references. 3 figures. 2 tables. 58 references. •

Streptococcal Toxic Shock Syndrome Associated With Necrotizing Fasciitis Source: in Coggins, C.H.; Hancock, E.W.; Levitt, L.J., eds. Annual Review of Medicine, Volume 51, 2000. Palo Alto, CA: Annual Reviews, Inc. 2000. p. 271-288. Contact: Available from Annual Reviews. 4139 El Camino Way, P.O. Box 10139, Palo Alto, CA 94303-0139. (650) 493-4400. E-mail: [email protected]. Website: www.AnnualReviews.org. Summary: This chapter provides health professionals with information on the demographics, symptoms, signs, diagnosis, clinical course, and treatment of streptococcal toxic shock syndrome (strep TSS) with associated necrotizing fasciitis. Strep TSS is the early onset of shock and organ failure associated with any infection caused by Streptococcus pyogenes. It is a rapidly progressive process that kills 30 to 60 percent of patients in 72 to 96 hours. The initial symptoms of strep TSS depend largely on the site of primary infection. Of all patients with strep TSS, 20 percent experience an influenza like syndrome characterized by fever, chills, myalgia, and diarrhea. In patients who develop deep soft tissue infections, such as necrotizing fasciitis or intrauterine infection, severe pain is the most common initial symptom of strep TSS. Violaceous bullae, hypotension, fever, and evidence of organ failure are late clinical manifestations. Diagnosis is not difficult when all the clinical features of strep TSS are manifest; however, the signs and symptoms may be quite subtle early in the course of illness, and laboratory tests may provide valuable clues to the diagnosis. The challenge to clinicians is to make an early diagnosis and to intervene with aggressive fluid replacement, emergent surgical debridement, and general supportive measures. Superantigens such as pyrogenic exotoxin A interact with monocytes and T lymphocytes in unique ways, resulting in T cell proliferation and watershed production of monokines and lymphokines. Penicillin, though efficacious in mild S. pyogenes infection, is less effective in severe infections because of its short postantibiotic effect, inoculum effect, and reduced activity against stationary phase organisms. Emerging treatments for strep TSS include clindamycin and intravenous gamma globulin. 2 tables and 81 references. (AA-M).

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Chapter 199: Sebaceous Gland Disorders Source: in Berkow, R., ed. The Merck Manual of Medical Information: Home Edition (online version). Rahway, NJ: Merck and Company, Inc. 2000. 5 p. Contact: Available online from Merck and Company, Inc. (800) 819-9456. Website: www.merck.com/pubs/mmanual_home/contents.htm. Also available from your local book store. PRICE: $29.95 plus shipping. Summary: This chapter provides the general public and people who have sebaceous gland disorders with information on the symptoms and treatment of acne, rosacea, perioral dermatitis, and sebaceous cysts. Acne is a common skin condition in which dried sebum, flaked skin, and bacteria collect in skin pores, forming a comedo, which blocks sebum from flowing from hair follicles up through the pores. Acne is often worse in the winter and better in the summer. Diet has little or no effect. Acne may also appear with each menstrual period in young women and may clear up or worsen during pregnancy. Certain cosmetics may aggravate acne. Superficial acne can be made worse

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by squeezing pimples or trying to open them in other ways. It can be treated by applying the antibiotic clindamycin or erythromycin to the skin. Certain oral antibiotics can reduce or prevent superficial acne. Sunlight can help because it dries the skin and causes slight scaling. Other helpful topical agents are benzoyl peroxide and preparations containing sulfur resorcinol. Deep acne is treated with an oral antibiotic or oral isotretinoin if antibiotics are ineffective. Although isotretinoin is very effective, it can have serious side effects, so a person taking this drug must be monitored. Rosacea is a persistent skin disorder of unknown etiology that produces redness, tiny pimples, and broken blood vessels, usually on the central area of the face. Treatment involves avoiding foods that cause blood vessels to dilate, taking oral antibiotics, and applying topical antibiotics. Perioral dermatitis, a red, often bumpy rash around the mouth and on the chin, can be caused by corticosteroids and by some oily cosmetics. Oral tetracyclines are usually the best treatment. Sebaceous cysts are yellowish or flesh colored bumps that contain dead skin, skin excretions, and other skin particles. These cysts are treated by either puncturing the top with a needle or cutting the top off with a scalpel, then squeezing out the contents. 1 figure.

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CHAPTER 7. PERIODICALS AND NEWS ON CLINDAMYCIN Overview In this chapter, we suggest a number of news sources and present various periodicals that cover clindamycin.

News Services and Press Releases One of the simplest ways of tracking press releases on clindamycin is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “clindamycin” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to clindamycin. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “clindamycin” (or synonyms). The following was recently listed in this archive for clindamycin: •

FDA clears Clindagel's generic Cleocin Topical Gel for acne Source: Reuters Industry Breifing Date: December 01, 2000

•

Clindamycin restriction reverses C. difficile outbreak Source: Reuters Medical News Date: June 15, 1998

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Clindamycin cream reduces preterm birth risk in women with abnormal flora Source: Reuters Industry Breifing Date: February 28, 2003

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Clindamycin-primaquine deemed best salvage therapy for P. carinii pneumonia Source: Reuters Industry Breifing Date: July 02, 2001

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Teva Suspends Clindamycin Sales Source: Reuters Medical News Date: August 14, 1997

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Low-Dose, Extended-Interval Clindamycin Has Good Bactericidal Activity Source: Reuters Medical News Date: March 10, 1997

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Bacterial Vaginosis: Metronidazole And Clindamycin Equally Effective Source: Reuters Medical News Date: November 30, 1995 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “clindamycin” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or

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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “clindamycin” (or synonyms). If you know the name of a company that is relevant to clindamycin, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “clindamycin” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “clindamycin” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on clindamycin: •

Use of Antibiotics in Periodontal Therapy Source: Oral Care Report. 11(4): 5,8. 2001. Contact: Available from Oral Care Report. c/o Dr. Chester W. Douglass, Department of Oral Health Policy, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115. Fax (617) 432-0047. E-mail: [email protected]. Website: www.colgateprofessional.com (full-text available online). Summary: This brief report reviews the use of antibiotics in periodontal therapy. Treatment of periodontitis is based on four scientific principles: that bacteria cause the disease; the disease is chronic in nature; clinicians cannot remove all plaque and calculus on infected root surfaces; and the disease is recurrent and cannot be cured. Clinical research has shown that scaling and root planing (SRP) combined with systemic antibiotic administration was more effective than SRP alone in certain patient groups and with particular forms of periodontitis. This article summarizes the outcome of trials with either tetracycline, Augmentin, clindamycin, or metronidazole. The author also outlines the potential adverse effects of systemic antibiotics and the development of antibiotic resistance. The author notes that given the varied success of antibiotic treatment for periodontitis, together with the concerns regarding antibiotic resistance, local delivery of antimicrobials offers a new strategy in the treatment of adult periodontitis for certain patient subgroups that do not respond favorably to conventional therapy alone. Local delivery of antibiotics offers the advantages of direct access to the site of periodontitis, a therapeutic level that is above the minimum inhibitory concentration, and a minimal uptake of the drug into the systemic circulation, which reduces side effects and drug interactions. 1 figure. 3 references.

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Academic Periodicals covering Clindamycin Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to clindamycin. In addition to these sources, you can search for articles covering clindamycin that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for clindamycin. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with clindamycin. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to clindamycin: Clindamycin •

Systemic - U.S. Brands: Cleocin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202145.html

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Topical - U.S. Brands: Clinda-Derm http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202146.html

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Vaginal - U.S. Brands: Cleocin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202700.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.

Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to clindamycin by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on

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“Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “clindamycin” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for clindamycin: •

Primaquine phosphate http://www.rarediseases.org/nord/search/nodd_full?code=425

If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

11

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “clindamycin” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 5697 24 358 223 27 6329

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “clindamycin” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

19 Adapted 20

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on clindamycin can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to clindamycin. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to clindamycin. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “clindamycin”:

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•

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Other guides Acne http://www.nlm.nih.gov/medlineplus/acne.html Dental Health http://www.nlm.nih.gov/medlineplus/dentalhealth.html Gum Disease http://www.nlm.nih.gov/medlineplus/gumdisease.html Hair Diseases and Hair Loss http://www.nlm.nih.gov/medlineplus/hairdiseasesandhairloss.html Rosacea http://www.nlm.nih.gov/medlineplus/rosacea.html Streptococcal Infections http://www.nlm.nih.gov/medlineplus/streptococcalinfections.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on clindamycin. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

PCP Treatment Contact: Project Inform, HIV Treatment Hotline, 205 13th St Ste 2001, San Francisco, CA, 94103, (415) 558-8669, http://www.projectinform.org. Summary: This fact sheet, for persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses the opportunistic infection, pneumocystis carinii pneumonia (PCP). The fact sheet examines the causes and symptoms of PCP. It explains diagnostic methods for determining PCP infection and the available medical treatments. The fact sheet also discusses the therapeutic drugs used to treat PCP. It provides information for each drug, as well as the side effects and possible drug interactions with other medications used to treat it or HIV/AIDS. The drugs discussed include trimethoprim-sulfamethoxazole (TMP/SMX), dapsone/trimoethoprim, clindamycin/primaquine, clindamycin/chloroquine, pentamidine, atovaquone, and trimetrexate. The fact sheet reviews adjunctive therapies for PCP treatment.

Patient Resources

•

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Toxoplasmosis Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, written for persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses the opportunistic infection, toxoplasmosis. Toxoplasmosis, also known as toxo, is the name of a treatable infection caused by the parasite Toxoplasma gondii. The fact sheet lists the ways HIV positive persons can contract toxoplasmosis. In persons with low CD4 cell counts, the immune system can no longer fight the virus and toxoplasmosis develops. A laboratory test called a Toxoplasma antibody test is used to determine if individuals have been infected by the parasite, but it does not determine whether or not the infection is active. The symptoms of toxoplasmosis may include fever, headache, confusion, sleepiness, weakness, numbness in one part of the body, seizure activity, and changes in vision. If left untreated, these symptoms can worsen and progress to coma and even death. Toxoplasmosis is diagnosed through a specialized radiologic study (CT or MRI scan) of the brain. This infection is treated using the therapeutic drugs sulfadiazine and pyrimethamine, leucovorin, clindamycin, clarithromycin, azithromycin, daspone, and atovaquone. Toxoplasma infection may be prevented by wearing gloves and washing hands when changing the litter in a cat box; not eating undercooked meats, raw eggs, or raw and unwashed vegetables; drinking unpasteurized milk; and undergoing preventive therapy with drugs such as trimethoprim-sulfamethoxazole (TMP-SMX), dapsone, or pyrimethamine. The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to clindamycin. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to clindamycin. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with clindamycin. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about clindamycin. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “clindamycin” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “clindamycin”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “clindamycin” (or synonyms) into the “For

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these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “clindamycin” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.22

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

22

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

23

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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CLINDAMYCIN DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: A localized, circumscribed collection of pus. [NIH] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Acremonium: A mitosporic fungal genus with many reported ascomycetous teleomorphs. Cephalosporin antibiotics are derived from this genus. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the

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tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

AK: Enzyme of the biosynthetic pathway. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alkylating Agents: Highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning. Many are used as antineoplastic agents, but most are very toxic, with carcinogenic, mutagenic, teratogenic, and immunosuppressant actions. They have also been used as components in poison gases. [NIH]

Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allogeneic: Taken from different individuals of the same species. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [NIH]

Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH]

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Amikacin: A broad-spectrum antibiotic derived from kanamycin. It is reno- and ototoxic like the other aminoglycoside antibiotics. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Aminoquinolines: Quinolines substituted in any position by one or more amino groups. [NIH]

Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anergy: Absence of immune response to particular substances. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anthrax: An acute bacterial infection caused by ingestion of bacillus organisms. Carnivores may become infected from ingestion of infected carcasses. It is transmitted to humans by contact with infected animals or contaminated animal products. The most common form in humans is cutaneous anthrax. [NIH]

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Antiallergic: Counteracting allergy or allergic conditions. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antifungal Agents: Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from fungicides, industrial because they defend against fungi present in human or animal tissues. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-infective: An agent that so acts. [EU] Anti-Infective Agents: Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antimycotic: Suppressing the growth of fungi. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antipruritic: Relieving or preventing itching. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apocrine Glands: Large, branched, specialized sweat glands that empty into the upper portion of a hair follicle instead of directly onto the skin. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH]

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Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Aqueous: Having to do with water. [NIH] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astringent: Causing contraction, usually locally after topical application. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Azithromycin: A semi-synthetic macrolide antibiotic structurally related to erythromycin. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis. [NIH] Aztreonam: A monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum. It is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. It may cause a superinfection with grampositive organisms. [NIH] Babesiosis: A group of tick-borne diseases of mammals including zoonoses in humans. They are caused by protozoans of the genus babesia, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick ixodes scapularis. [NIH] Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [NIH] Bacteraemia: The presence of bacteria in the blood. [EU] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the

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coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Bacteroides: A genus of gram-negative, anaerobic, rod-shaped bacteria. Its organisms are normal inhabitants of the oral, respiratory, intestinal, and urogenital cavities of humans, animals, and insects. Some species may be pathogenic. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzoyl Peroxide: A peroxide derivative that has been used topically for burns and as a dermatologic agent in the treatment of acne and poison ivy. It is used also as a bleach in the food industry. [NIH] Benzyl Alcohol: A colorless liquid with a sharp burning taste and slight odor. It is used as a local anesthetic and to reduce pain associated with lidocaine injection. Also, it is used in the manufacture of other benzyl compounds, as a pharmaceutic aid, and in perfumery and flavoring. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH]

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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bioterrorism: The use of biological agents in terrorism. This includes the malevolent use of bacteria, viruses, or toxins against people, animals, or plants. [NIH] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bismuth Subsalicylate: A nonprescription medicine such as Pepto-Bismol. Used to treat diarrhea, heartburn, indigestion, and nausea. It is also part of the treatment for ulcers caused by the bacterium Helicobacter pylori (HELL-uh-koh-BAK-tur py-LOH-ree). [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH]

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Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbenicillin: Broad-spectrum semisynthetic penicillin derivative used parenterally. It is susceptible to gastric juice and penicillinase and may damage platelet function. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Cardiac: Having to do with the heart. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catheters: A small, flexible tube that may be inserted into various parts of the body to inject or remove liquids. [NIH] Cefaclor: Semisynthetic, broad-spectrum antibiotic derivative of cephalexin. [NIH] Cefazolin: Semisynthetic cephalosporin analog with broad-spectrum antibiotic action due to inhibition of bacterial cell wall synthesis. It attains high serum levels and is excreted quickly via the urine. [NIH] Cefonicid: A second-generation cephalosporin administered intravenously or intramuscularly. Its bactericidal action results from inhibition of cell wall synthesis. It is effective in the treatment of urinary tract infections, lower respiratory tract infections, and soft tissue and bone infections. [NIH] Cefoperazone: Semisynthetic broad-spectrum cephalosporin with a tetrazolyl moiety that is resistant to beta-lactamase. It has been proposed especially against Pseudomonas infections. [NIH]

Cefotaxime: Semisynthetic broad-spectrum cephalosporin. [NIH] Cefoxitin: Semisynthetic cephamycin antibiotic resistant to beta-lactamase. [NIH]

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Ceftazidime: Semisynthetic, broad-spectrum antibacterial derived from cephaloridine and used especially for Pseudomonas and other gram-negative infections in debilitated patients. [NIH]

Ceftriaxone: Broad-spectrum cephalosporin antibiotic with a very long half-life and high penetrability to usually inaccessible infections, including those involving the meninges, eyes, inner ears, and urinary tract. [NIH] Cefuroxime: Broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. It has been proposed for infections with gram-negative and gram-positive organisms, gonorrhea, and haemophilus. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cellulitis: An acute, diffuse, and suppurative inflammation of loose connective tissue, particularly the deep subcutaneous tissues, and sometimes muscle, which is most commonly seen as a result of infection of a wound, ulcer, or other skin lesions. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cephalexin: A semisynthetic cephalosporin antibiotic with antimicrobial activity similar to that of cephaloridine or cephalothin, but somewhat less potent. It is effective against both gram-positive and gram-negative organisms. [NIH] Cephaloridine: A cephalosporin antibiotic. [NIH] Cephalosporins: A group of broad-spectrum antibiotics first isolated from the Mediterranean fungus Acremonium (Cephalosporium acremonium). They contain the betalactam moiety thia-azabicyclo-octenecarboxylic acid also called 7-aminocephalosporanic acid. [NIH] Cephalothin: A cephalosporin antibiotic. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH]

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Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Chemical Warfare: Tactical warfare using incendiary mixtures, smokes, or irritant, burning, or asphyxiating gases. [NIH] Chemical Warfare Agents: Chemicals that are used to cause the disturbance, disease, or death of humans during war. [NIH] Chemotaxis: The movement of cells or organisms toward or away from a substance in response to its concentration gradient. [NIH] Chemotherapeutics: Noun plural but singular or plural in constructions : chemotherapy. [EU]

Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholestyramine: Strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium as Cl(-) anion. It exchanges chloride ions with bile salts, thus decreasing their concentration and that of cholesterol. It is used as a hypocholesteremic in diarrhea and biliary obstruction and as an antipruritic. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic prostatitis: Inflammation of the prostate gland, developing slowly and lasting a long time. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] Cilastatin: A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, imipenem, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukeotriene E4. [NIH]

Cinchona: A genus of rubiaceous South American trees that yields the toxic cinchona alkaloids from their bark; quinine, quinidine, chinconine, cinchonidine and others are used to treat malaria and cardiac arrhythmias. [NIH] Ciprofloxacin: A carboxyfluoroquinoline antimicrobial agent that is effective against a wide range of microorganisms. It has been successfully and safely used in the treatment of resistant respiratory, skin, bone, joint, gastrointestinal, urinary, and genital infections. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is

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active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clavulanic Acid: Clavulanic acid (C8H9O5N) and its salts and esters. The acid is a suicide inhibitor of bacterial beta-lactamase enzymes from Streptomyces clavuligerus. Administered alone, it has only weak antibacterial activity against most organisms, but given in combination with beta-lactam antibiotics prevents antibiotic inactivation by microbial lactamase. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clindamycin: An antibacterial agent that is a semisynthetic analog of lincomycin. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]

Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clotrimazole: An imidazole derivative with a broad spectrum of antimycotic activity. It inhibits biosynthesis of the sterol ergostol, an important component of fungal cell membranes. Its action leads to increased membrane permeability and apparent disruption of enzyme systems bound to the membrane. [NIH] Cloxacillin: A semi-synthetic antibiotic that is a chlorinated derivative of oxacillin. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colitis: Inflammation of the colon. [NIH] Colloidal: Of the nature of a colloid. [EU] Colony-Stimulating Factors: Glycoproteins found in a subfraction of normal mammalian plasma and urine. They stimulate the proliferation of bone marrow cells in agar cultures and the formation of colonies of granulocytes and/or macrophages. The factors include interleukin-3 (IL-3), granulocyte colony-stimulating factor (G-CSF), macrophage colonystimulating factor (M-CSF), and granulocyte-macrophage colony-stimulating factor (GMCSF). [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Surgery: A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the colon, rectum, and anal canal. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Comedo: A plug of keratin and sebum within the dilated orifice of a hair follicle, frequently containing the bacteria Propionibacterium acnes, Staphylococcus albus, and Pityrosporon

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ovale; called also blackhead. [EU] Commensal: 1. Living on or within another organism, and deriving benefit without injuring or benefiting the other individual. 2. An organism living on or within another, but not causing injury to the host. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH]

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Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congenita: Displacement, subluxation, or malposition of the crystalline lens. [NIH] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]

Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Conventional therapy: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional treatment. [NIH] Conventional treatment: A currently accepted and widely used treatment for a certain type of disease, based on the results of past research. Also called conventional therapy. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial

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structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cryptosporidiosis: Parasitic intestinal infection with severe diarrhea caused by a protozoan, Cryptosporidium. It occurs in both animals and humans. [NIH] Cultured cells: Animal or human cells that are grown in the laboratory. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Curettage: Removal of tissue with a curette, a spoon-shaped instrument with a sharp edge. [NIH]

Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Decontamination: The removal of contaminating material, such as radioactive materials, biological materials, or chemical warfare agents, from a person or object. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Polishing: Creation of a smooth and glossy surface finish on a denture or amalgam. [NIH]

Dental Prophylaxis: Treatment for the prevention of periodontal diseases or other dental diseases by the cleaning of the teeth in the dental office using the procedures of dental scaling and dental polishing. The treatment may include plaque detection, removal of supraand subgingival plaque and calculus, application of caries-preventing agents, checking of restorations and prostheses and correcting overhanging margins and proximal contours of restorations, and checking for signs of food impaction. [NIH] Dental Scaling: Removal of dental plaque and dental calculus from the surface of a tooth, from the surface of a tooth apical to the gingival margin accumulated in periodontal pockets, or from the surface coronal to the gingival margin. [NIH]

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Dentists: Individuals licensed to practice dentistry. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatitis, Allergic Contact: A contact dermatitis due to allergic sensitization to various substances. These substances subsequently produce inflammatory reactions in the skin of those who have acquired hypersensitivity to them as a result of prior exposure. [NIH] Dermatologist: A doctor who specializes in the diagnosis and treatment of skin problems. [NIH]

Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Developing Countries: Countries in the process of change directed toward economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Foot: Ulcers of the foot as a complication of diabetes. Diabetic foot, often with infection, is a common serious complication of diabetes and may require hospitalization and disfiguring surgery. The foot ulcers are probably secondary to neuropathies and vascular problems. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach,

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liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilate: Relax; expand. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Doxycycline: A synthetic tetracycline derivative with a range of antimicrobial activity and mode of action similar to that of tetracycline, but more effective against many species. Animal studies suggest that it may cause less tooth staining than other tetracyclines. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH]

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Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Emetic: An agent that causes vomiting. [EU] Emollient: Softening or soothing; called also malactic. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU]

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Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endophthalmitis: Suppurative inflammation of the tissues of the internal structures of the eye; not all layers of the uvea are affected. Fungi, necrosis of intraocular tumors, and retained intraocular foreign bodies often cause a purulent endophthalmitis. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotoxin: Toxic substance excreted by living bacterial cells. [NIH]

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Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extraction: The process or act of pulling or drawing out. [EU] Facial: Of or pertaining to the face. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Flatus: Gas passed through the rectum. [NIH] Fleroxacin: A third-generation fluoroquinolone derivative with a broad antimicrobial spectrum. The drug strongly inhibits the DNA-supercoiling activity of DNA gyrase which may account for its antibacterial activity. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic

Acid:

N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-L-

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glutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Foot Ulcer: Lesion on the surface of the skin of the foot, usually accompanied by inflammation. The lesion may become infected or necrotic and is frequently associated with diabetes or leprosy. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Formulary: A book containing a list of pharmaceutical products with their formulas and means of preparation. [NIH] Fumigation: The application of smoke, vapor, or gas for the purpose of disinfecting or destroying pests or microorganisms. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungicides, Industrial: Chemicals that kill or inhibit the growth of fungi in agricultural applications, on wood, plastics, or other materials, in swimming pools, etc. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas Gangrene: A severe condition resulting from bacteria invading healthy muscle from adjacent traumatized muscle or soft tissue. The infection originates in a wound contaminated with bacteria of the genus Clostridium. C. perfringens accounts for the majority of cases (over eighty percent), while C. noyvi, C. septicum, and C. histolyticum cause most of the other cases. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several

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different kinds of cells. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ cell tumors: Tumors that begin in the cells that give rise to sperm or eggs. They can occur virtually anywhere in the body and can be either benign or malignant. [NIH] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]

Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid

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metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]

Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonorrhea: Acute infectious disease characterized by primary invasion of the urogenital tract. The etiologic agent, Neisseria gonorrhoeae, was isolated by Neisser in 1879. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-Negative Anaerobic Bacteria: A large group of anaerobic bacteria which show up as pink (negative) when treated by the Gram staining method. [NIH] Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method. [NIH] Gram-Positive Bacterial Infections: Infections caused by bacteria that retain the crystal violet stain (positive) when treated by the gram-staining method. [NIH] Granule: A small pill made from sucrose. [EU] Granulocyte Colony-Stimulating Factor: A glycoprotein of MW 25 kDa containing internal disulfide bonds. It induces the survival, proliferation, and differentiation of neutrophilic granulocyte precursor cells and functionally activates mature blood neutrophils. Among the family of colony-stimulating factors, G-CSF is the most potent inducer of terminal differentiation to granulocytes and macrophages of leukemic myeloid cell lines. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Gyrase: An enzyme that causes negative supercoiling of E. coli DNA during replication. [NIH]

Haemophilus: A genus of Pasteurellaceae that consists of several species occurring in animals and humans. Its organisms are described as gram-negative, facultatively anaerobic, coccobacillus or rod-shaped, and nonmotile. [NIH]

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Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hematologic Diseases: Disorders of the blood and blood forming tissues. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hidradenitis: The inflammation of a sweat gland (usually of the apocrine type). The condition can be idiopathic or occur as a result of or in association with another underlying condition. Neutrophilic eccrine hidradenitis is a relatively rare variant that has been reported in patients undergoing chemotherapy, usually for non-Hodgkin lymphomas or leukemic conditions. [NIH] Hidradenitis Suppurativa: A chronic suppurative and cicatricial disease of the apocrine glands occurring chiefly in the axillae in women and in the groin and anal regions in men. It is characterized by poral occlusion with secondary bacterial infection, evolving into abscesses which eventually rupture. As the disease becomes chronic, ulcers appear, sinus tracts enlarge, fistulas develop, and fibrosis and scarring become evident. Hormonal mechanisms are expected in its pathogenesis. [NIH]

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Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipenem: Semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. It is stable to beta-lactamases. Clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. Its effectiveness is enhanced when it is administered in combination with cilastatin, a renal dipeptidase inhibitor. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and

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disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incubated: Grown in the laboratory under controlled conditions. (For instance, white blood cells can be grown in special conditions so that they attack specific cancer cells when returned to the body.) [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU]

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Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Inoculum: The spores or tissues of a pathogen that serve to initiate disease in a plant. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intramuscular injection: IM. Injection into a muscle. [NIH] Intraocular: Within the eye. [EU] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Isotretinoin: A topical dermatologic agent that is used in the treatment of acne vulgaris and several other skin diseases. The drug has teratogenic and other adverse effects. [NIH] Ixodes: A large, widely distributed genus of ticks consisting of approximately 245 species. Many infest man and other mammals and several are vectors of diseases such as Lyme disease, tick-borne encephalitis (encephalitis, tick-borne), and Kyasanur forest disease. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kanamycin: Antibiotic complex produced by Streptomyces kanamyceticus from Japanese soil. Comprises 3 components: kanamycin A, the major component, and kanamycins B and C, the minor components. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH]

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Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Lactation: The period of the secretion of milk. [EU] Lactobacillus: A genus of gram-positive, microaerophilic, rod-shaped bacteria occurring widely in nature. Its species are also part of the many normal flora of the mouth, intestinal tract, and vagina of many mammals, including humans. Pathogenicity from this genus is rare. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leishmaniasis: A disease caused by any of a number of species of protozoa in the genus Leishmania. There are four major clinical types of this infection: cutaneous (Old and New World), diffuse cutaneous, mucocutaneous, and visceral leishmaniasis. [NIH] Lethal: Deadly, fatal. [EU] Leucovorin: The active metabolite of folic acid. Leucovorin is used principally as its calcium salt as an antidote to folic acid antagonists which block the conversion of folic acid to folinic acid. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levofloxacin: A substance used to treat bacterial infections. It belongs to the family of drugs called quinolone antibiotics. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Lincomycin: (2S-trans)-Methyl 6,8-dideoxy-6-(((1-methyl-4-propyl-2pyrrolidinyl)carbonyl)amino)-1-thio-D-erythro-alpha-D-galacto-octopyranoside. An antibiotic produced by Streptomyces lincolnensis var. lincolnensis. It has been used in the treatment of staphylococcal, streptococcal, and Bacteroides fragilis infections. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH]

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Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]

Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Litter: Appliance consisting of an oblong frame over which is stretched a canvas or other material, used for carrying an injured or disabled person. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphokines: Soluble protein factors generated by activated lymphocytes that affect other cells, primarily those involved in cellular immunity. [NIH] Macrolides: A group of organic compounds that contain a macrocyclic lactone ring linked glycosidically to one or more sugar moieties. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely

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expressed in behaviour. [EU] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] Mezlocillin: Semisynthetic ampicillin-derived acylureido penicillin. It has been proposed for infections with certain anaerobes and may be useful in inner ear, bile, and CNS infections. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living

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organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microsporidiosis: Infections with protozoa of the phylum Microspora. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Minocycline: A semisynthetic staphylococcus infections. [NIH]

antibiotic

effective

against

tetracycline-resistant

Miocamycin: A macrolide antibiotic that has a wide antimicrobial spectrum and is particularly effective in respiratory and genital infections. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Monokines: Soluble mediators of the immune response that are neither antibodies nor complement. They are produced largely, but not exclusively, by monocytes and macrophages. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Moxalactam: Broad- spectrum beta-lactam antibiotic similar in structure to the cephalosporins except for the substitution of an oxaazabicyclo moiety for the thiaazabicyclo moiety of certain cephalosporins. It has been proposed especially for the meningitides because it passes the blood-brain barrier and for anaerobic infections. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH]

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Myalgia: Pain in a muscle or muscles. [EU] Mycoplasma: A genus of gram-negative, facultatively anaerobic bacteria bounded by a plasma membrane only. Its organisms are parasites and pathogens, found on the mucous membranes of humans, animals, and birds. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Nebramycin: A complex of antibiotic substances produced by Streptomyces tenebrarius. [NIH]

Necrolysis: Separation or exfoliation of tissue due to necrosis. [EU] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Blockade: The intentional interruption of transmission at the neuromuscular junction by external agents, usually neuromuscular blocking agents. It is distinguished from nerve block in which nerve conduction is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce muscle relaxation as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH]

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Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutropenia: An abnormal decrease in the number of neutrophils, a type of white blood cell. [NIH] Neutrophil: A type of white blood cell. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleolus: A small dense body (sub organelle) within the nucleus of eukaryotic cells, visible by phase contrast and interference microscopy in live cells throughout interphase. Contains RNA and protein and is the site of synthesis of ribosomal RNA. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ofloxacin: An orally administered broad-spectrum quinolone antibacterial drug active against most gram-negative and gram-positive bacteria. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligosaccharides: Carbohydrates consisting of between two and ten monosaccharides connected by either an alpha- or beta-glycosidic link. They are found throughout nature in both the free and bound form. [NIH] Operon: The genetic unit consisting of a feedback system under the control of an operator gene, in which a structural gene transcribes its message in the form of mRNA upon blockade of a repressor produced by a regulator gene. Included here is the attenuator site of bacterial operons where transcription termination is regulated. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Ornidazole: A nitroimidazole antiprotozoal agent used in ameba and trichomonas infections. It is partially plasma-bound and also has radiation-sensitizing action. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osteomyelitis: Inflammation of bone caused by a pyogenic organism. It may remain

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localized or may spread through the bone to involve the marrow, cortex, cancellous tissue, and periosteum. [EU] Ototoxic: Having a deleterious effect upon the eighth nerve, or upon the organs of hearing and balance. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Oxacillin: An antibiotic similar to flucloxacillin used in resistant staphylococci infections. [NIH]

Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palmitates: Salts and esters of the 16-carbon saturated monocarboxylic acid--palmitic acid. [NIH]

Palmitic Acid: A common saturated fatty acid found in fats and waxes including olive oil, palm oil, and body lipids. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH]

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Penicillin V: A broad-spectrum penicillin antibiotic used orally in the treatment of mild to moderate infections by susceptible gram-positive organisms. [NIH] Penicillinase: A beta-lactamase preferentially cleaving penicillins. (Dorland, 28th ed) EC 3.5.2.-. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pentamidine: Antiprotozoal agent effective in trypanosomiasis, leishmaniasis, and some fungal infections; used in treatment of Pneumocystis carinii pneumonia in HIV-infected patients. It may cause diabetes mellitus, central nervous system damage, and other toxic effects. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericoronitis: Inflammation of the gingiva surrounding the crown of a tooth. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal Pocket: An abnormal extension of a gingival sulcus accompanied by the apical migration of the epithelial attachment and bone resorption. [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Perioral: Situated or occurring around the mouth. [EU] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Peroxide: Chemical compound which contains an atom group with two oxygen atoms tied to each other. [NIH] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use,

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they do not fall into another group of products. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharyngitis: Inflammation of the throat. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phosphates: Inorganic salts of phosphoric acid. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photoreceptors: Cells specialized to detect and transduce light. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Piperacillin: Semisynthetic, broad-spectrum, ampicillin-derived ureidopenicillin antibiotic proposed for pseudomonas infections. It is also used in combination with other antibiotics. [NIH]

Piperacillin-tazobactam: A combination of drugs used to fight infections in people who have cancer. Piperacillin is a synthetic penicillin; tazobactam enhances the effectiveness of piperacillin. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH]

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Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promyelocytic leukemia: A type of acute myeloid leukemia, a quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. [NIH]

Prophylaxis: An attempt to prevent disease. [NIH] Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. [NIH]

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Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatitis: Inflammation of the prostate. [EU] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific proteinbinding measures are often used as assays in diagnostic assessments. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pseudomembranous Colitis: Severe irritation of the colon. Caused by Clostridium difficile bacteria. Occurs after taking oral antibiotics, which kill bacteria that normally live in the colon. [NIH] Pseudomonas: A genus of gram-negative, aerobic, rod-shaped bacteria widely distributed in nature. Some species are pathogenic for humans, animals, and plants. [NIH] Pseudomonas Infections: Infections with bacteria of the genus Pseudomonas. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.

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[NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyelonephritis: Inflammation of the kidney and its pelvis, beginning in the interstitium and rapidly extending to involve the tubules, glomeruli, and blood vessels; due to bacterial infection. [EU] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Pyrogenic: Inducing fever. [EU] Quinidine: An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular action potential, and decreases automaticity. Quinidine also blocks muscarinic and alphaadrenergic neurotransmission. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Quinolones: Quinolines which are substituted in any position by one or more oxo groups. These compounds can have any degree of hydrogenation, any substituents, and fused ring systems. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Ramus: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

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Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reactivation: The restoration of activity to something that has been inactivated. [EU] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Repressor: Any of the specific allosteric protein molecules, products of regulator genes, which bind to the operator of operons and prevent RNA polymerase from proceeding into the operon to transcribe messenger RNA. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The

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outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rifamycins: A group of antibiotics characterized by a chromophoric naphthohydroquinone group spanned by an aliphatic bridge not previously found in other known antibiotics. They have been isolated from fermentation broths of Streptomyces mediterranei. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Ristocetin: An antibiotic mixture of two components, A and B, obtained from Nocardia lurida (or the same substance produced by any other means). It is no longer used clinically because of its toxicity. It causes platelet agglutination and blood coagulation and is used to assay those functions in vitro. [NIH] Rod: A reception for vision, located in the retina. [NIH] Root Planing: A procedure for smoothing of the roughened root surface or cementum of a tooth after subgingival curettage or scaling, as part of periodontal therapy. [NIH] Roxithromycin: Semisynthetic derivative of erythromycin. It is concentrated by human phagocytes and is bioactive intracellularly. While the drug is active against a wide spectrum of pathogens, it is particularly effective in the treatment of respiratory and genital tract infections. [NIH] Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salvage Therapy: A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases. [NIH]

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Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Scalpel: A small pointed knife with a convex edge. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock.

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[NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skin Tests: Epicutaneous or intradermal application of a sensitizer for demonstration of either delayed or immediate hypersensitivity. Used in diagnosis of hypersensitivity or as a test for cellular immunity. [NIH] Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spiramycin: A macrolide antibiotic produced by Streptomyces ambofaciens. The drug is effective against gram-positive aerobic pathogens, N. gonorrhoeae, and staphylococci. It is used to treat infections caused by bacteria and Toxoplasma gondii. [NIH] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and

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cryptogamic plants. [NIH] Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stillbirth: The birth of a dead fetus or baby. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococcal Infections: Infections with bacteria of the genus Streptococcus. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Styptic: Astringent. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus

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extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. [NIH] Sulfadiazine: A short-acting sulfonamide used in combination with pyrimethamine to treat toxoplasmosis in patients with acquired immunodeficiency syndrome and in newborns with congenital infections. [NIH] Sulfadoxine: A long acting sulfonamide that is used, usually in combination with other drugs, for respiratory, urinary tract, and malarial infections. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superantigens: Microbial antigens that have in common an extremely potent activating effect on T-cells that bear a specific variable region. Superantigens cross-link the variable region with class II MHC proteins regardless of the peptide binding in the T-cell receptor's pocket. The result is a transient expansion and subsequent death and anergy of the T-cells with the appropriate variable regions. [NIH] Superinfection: A frequent complication of drug therapy for microbial infection. It may result from opportunistic colonization following immunosuppression by the primary pathogen and can be influenced by the time interval between infections, microbial physiology, or host resistance. Experimental challenge and in vitro models are sometimes used in virulence and infectivity studies. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Suppurative: Consisting of, containing, associated with, or identified by the formation of pus. [NIH] Surface-Active Agents: Agents that modify interfacial tension of water; usually substances that have one lipophilic and one hydrophilic group in the molecule; includes soaps, detergents, emulsifiers, dispersing and wetting agents, and several groups of antiseptics. [NIH]

Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Systemic: Affecting the entire body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH]

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Teichoic Acids: Bacterial polysaccharides that are rich in phosphodiester linkages. They are the major components of the cell walls and membranes of many bacteria. [NIH] Teicoplanin: Glycopeptide antibiotic complex from Actinoplanes teichomyceticus active against gram-positive bacteria. It consists of five major components each with a different fatty acid moiety. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Tetracycline Resistance: Nonsusceptibility of a microbe (usually a bacterium) to the action of tetracycline, which binds to the 30S ribosomal subunit and prevents the normal binding of aminoacyl-tRNA. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Ticarcillin: An antibiotic derived from penicillin similar to carbenicillin in action. [NIH] Tick-Borne Diseases: Bacterial, viral, or parasitic diseases transmitted to humans and animals by the bite of infected ticks. The families Ixodidae and Argasidae contain many bloodsucking species that are important pests of man and domestic birds and mammals and probably exceed all other arthropods in the number and variety of disease agents they transmit. Many of the tick-borne diseases are zoonotic. [NIH] Tinidazole: A nitroimidazole antitrichomonal agent effective against Trichomonas vaginalis, Entamoeba histolytica, and Giardia lamblia infections. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tobramycin: An aminoglycoside, broad-spectrum antibiotic produced by Streptomyces tenebrarius. It is effective against gram-negative bacteria, especially the Pseudomonas species. It is a 10% component of the antibiotic complex, nebramycin, produced by the same species. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonsillitis: Inflammation of the tonsils, especially the palatine tonsils. It is often caused by a bacterium. Tonsillitis may be acute, chronic, or recurrent. [NIH] Tonsils: Small masses of lymphoid tissue on either side of the throat. [NIH] Topical: On the surface of the body. [NIH]

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Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tretinoin: An important regulator of gene expression, particularly during growth and development and in neoplasms. Retinoic acid derived from maternal vitamin A is essential for normal gene expression during embryonic development and either a deficiency or an excess can be teratogenic. It is also a topical dermatologic agent which is used in the treatment of psoriasis, acne vulgaris, and several other skin diseases. It has also been approved for use in promyelocytic leukemia. [NIH] Trichomonas: A genus of parasitic flagellate protozoans distinguished by the presence of four anterior flagella, an undulating membrane, and a trailing flagellum. [NIH] Trichomonas Infections: Infections in birds and mammals produced by various species of Trichomonas. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Trimethoprim-sulfamethoxazole: An antibiotic drug used to treat infection and prevent pneumocystis carinii pneumonia. [NIH] Trimetrexate: A nonclassical folic acid inhibitor through its inhibition of the enzyme dihydrofolate reductase. It is being tested for efficacy as an antineoplastic agent and as an antiparasitic agent against Pneumocystis carinii pneumonia in AIDS patients. Myelosuppression is its dose-limiting toxic effect. [NIH] Trypanosomiasis: Infection with protozoa of the genus Trypanosoma. [NIH]

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Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uracil: An anticancer drug that belongs to the family of drugs called alkylating agents. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital Diseases: Diseases of the urogenital tract. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginal Discharge: A common gynecologic disorder characterized by an abnormal, nonbloody discharge from the genital tract. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH]

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Vaginosis: A condition caused by the overgrowth of anaerobic bacteria (e. g., Gardnerella vaginalis), resulting in vaginal irritation and discharge. [NIH] Vancomycin: Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Wetting Agents: A surfactant that renders a surface wettable by water or enhances the spreading of water over the surface; used in foods and cosmetics; important in contrast media; also with contact lenses, dentures, and some prostheses. Synonyms: humectants; hydrating agents. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Wound Infection: Invasion of the site of trauma by pathogenic microorganisms. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zinc Acetate: A salt produced by the reaction of zinc oxide with acetic acid and used as an astringent, styptic, and emetic. [NIH] Zinc Oxide: A mild astringent and topical protectant with some antiseptic action. It is also used in bandages, pastes, ointments, dental cements, and as a sunblock. [NIH] Zoonoses: Diseases of non-human animals that may be transmitted to man or may be transmitted from man to non-human animals. [NIH]

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INDEX A Abdominal, 7, 33, 34, 48, 52, 54, 57, 62, 64, 79, 129, 138, 154, 161, 162, 175 Abdominal Pain, 129, 162, 175 Abscess, 49, 59, 68, 94, 129, 147 Acne Vulgaris, 20, 21, 23, 27, 31, 34, 36, 38, 56, 57, 58, 62, 72, 85, 129, 154, 174 Acquired Immunodeficiency Syndrome, 83, 129, 172 Acremonium, 129, 137 Acute renal, 129, 151 Acyl, 81, 129 Adenosine, 129, 163 Adjustment, 86, 129 Adrenal Cortex, 129, 141, 164 Adrenergic, 129, 166 Adverse Effect, 101, 129, 154, 170 Aerobic, 6, 11, 13, 83, 129, 152, 165, 170 Aerosol, 129, 172 Affinity, 129, 155, 170 Agar, 130, 139, 163 AK, 24, 130 Algorithms, 130, 135 Alimentary, 130, 161 Alkaline, 130, 131, 136 Alkaloid, 130, 166 Alkylating Agents, 130, 175 Alleles, 5, 130 Allergen, 130, 143, 169 Allogeneic, 40, 130 Allylamine, 130, 131 Alternative medicine, 100, 130 Ambulatory Care, 130 Amebiasis, 130, 157 Amikacin, 7, 27, 131 Amine, 81, 84, 131 Amino Acids, 84, 131, 146, 162, 164, 165, 168, 172, 174 Aminoquinolines, 93, 131 Ammonia, 131, 172 Amoxicillin, 7, 18, 37, 39, 86, 96, 131 Ampicillin, 7, 22, 33, 37, 51, 57, 59, 131, 157, 163 Anaerobic, 6, 7, 13, 15, 17, 18, 22, 70, 79, 83, 86, 131, 134, 150, 152, 158, 159, 171, 176 Anal, 131, 139, 151 Analgesic, 131, 166

Analog, 13, 81, 84, 88, 131, 136, 139 Analogous, 88, 131, 174 Anatomical, 131, 138, 153 Androgens, 129, 131, 141 Anemia, 84, 131, 148, 156 Anergy, 131, 172 Anesthesia, 49, 131, 159 Anorectal, 49, 131 Anthrax, 5, 131 Antiallergic, 132, 141 Antibacterial, 13, 78, 86, 89, 90, 132, 137, 139, 147, 152, 160, 170, 171, 176 Antibiotic Prophylaxis, 26, 32, 48, 132 Antibodies, 132, 151, 156, 158 Antibody, 117, 130, 132, 140, 152, 153, 166, 169, 170 Antidote, 132, 155 Antifungal, 80, 132 Antifungal Agents, 80, 132 Antigen, 130, 132, 140, 152, 153, 169 Anti-infective, 59, 95, 132, 170 Anti-Infective Agents, 59, 132 Anti-inflammatory, 88, 132, 141, 143, 149 Anti-Inflammatory Agents, 88, 132, 141 Antimycotic, 132, 139 Antineoplastic, 130, 132, 141, 174 Antipruritic, 132, 138 Antipyretic, 132, 166 Anus, 131, 132, 135, 167 Apocrine Glands, 132, 151 Aponeurosis, 132, 148 Appendicitis, 20, 45, 50, 133 Applicability, 73, 133 Aqueous, 79, 87, 89, 133, 134, 142, 156 Arrhythmia, 84, 133, 176 Arterial, 39, 57, 130, 133, 152, 165, 172 Arteries, 133, 135, 141, 157 Arterioles, 133, 135 Aspiration, 21, 133 Assay, 11, 133, 168 Astringent, 133, 171, 176 Asymptomatic, 6, 37, 60, 83, 130, 133 Atmospheric Pressure, 52, 133, 152 Attenuated, 133, 144 Atypical, 59, 133 Azithromycin, 7, 10, 12, 17, 18, 33, 54, 95, 117, 133 Aztreonam, 11, 27, 33, 38, 48, 54, 62, 133

178

Clindamycin

B Babesiosis, 41, 63, 133, 166 Bacillus, 5, 14, 30, 131, 133 Bacteraemia, 32, 39, 40, 133 Bacteremia, 55, 133 Bacterial Infections, 86, 90, 91, 92, 133, 137, 155 Bactericidal, 8, 16, 23, 24, 46, 52, 100, 133, 136 Bacteriophage, 133, 163 Bacteriostatic, 134, 146 Bacterium, 134, 135, 151, 173 Bacteriuria, 82, 134 Bacteroides, 8, 10, 12, 14, 15, 17, 18, 20, 23, 24, 27, 34, 42, 44, 79, 134, 155 Basal Ganglia, 134, 148 Base, 5, 80, 81, 87, 90, 91, 92, 134, 142, 154 Basophils, 134, 150, 155 Benign, 134, 148, 149, 151, 159 Benzoyl Peroxide, 20, 21, 23, 29, 32, 34, 38, 49, 55, 56, 58, 78, 79, 89, 97, 134 Benzyl Alcohol, 87, 134 Beta-Lactamases, 14, 133, 134, 152, 171 Bewilderment, 134, 141 Bilateral, 50, 134 Bile, 24, 62, 86, 134, 138, 148, 153, 156, 157, 171 Bile Acids, 62, 134, 171 Bile Acids and Salts, 134 Biliary, 134, 138 Biochemical, 130, 135 Biological Transport, 135, 143 Biosynthesis, 135, 139 Biotechnology, 6, 19, 100, 111, 135 Bioterrorism, 5, 135 Bismuth, 62, 64, 135 Bismuth Subsalicylate, 62, 135 Bladder, 133, 135, 165, 167, 175 Blastocyst, 135, 140, 145, 163 Blood Coagulation, 135, 136, 168 Blood Platelets, 135, 173 Blood pressure, 83, 135, 152, 170 Blood vessel, 97, 135, 136, 138, 151, 162, 166, 170, 171, 173, 176 Blood-Brain Barrier, 135, 158 Body Fluids, 83, 135, 144, 170 Bone Marrow, 40, 68, 74, 135, 139, 156, 158, 164 Bowel, 131, 135, 143, 146, 154, 162, 175 Bowel Movement, 135, 143 Branch, 125, 136, 161, 170, 173 Breakdown, 136, 143, 148

Broad-spectrum, 131, 136, 137, 160, 162, 163, 173 Burns, 134, 136 C Calcium, 74, 84, 136, 140, 155, 176 Calcium channel blocker, 136, 176 Capsules, 136, 144, 149 Carbenicillin, 136, 173 Carbohydrate, 136, 141, 149 Carbon Dioxide, 5, 70, 136, 163, 167 Carcinogen, 136, 157 Carcinogenic, 130, 136, 171 Cardiac, 84, 130, 136, 138, 145, 146, 148, 155, 159, 166, 171 Case report, 46, 136 Catheters, 36, 136 Cefaclor, 7, 136 Cefazolin, 9, 32, 56, 136 Cefonicid, 8, 29, 136 Cefoperazone, 8, 33, 136 Cefotaxime, 15, 45, 136 Cefoxitin, 10, 12, 13, 15, 16, 18, 34, 51, 54, 136 Ceftazidime, 9, 13, 17, 28, 137 Ceftriaxone, 18, 22, 32, 39, 47, 54, 137 Cefuroxime, 7, 137 Cell Count, 117, 137 Cell Division, 133, 137, 163, 169 Cell membrane, 135, 137, 139 Cell proliferation, 96, 137 Cellulitis, 94, 137 Central Nervous System, 64, 74, 137, 148, 151, 162 Central Nervous System Infections, 137, 151 Centrifugation, 82, 137 Cephalexin, 136, 137 Cephaloridine, 137 Cephalosporins, 20, 94, 95, 134, 137, 158 Cephalothin, 14, 137 Cerebral, 20, 74, 134, 135, 137, 138, 156 Cerebrospinal, 16, 47, 137 Cerebrospinal fluid, 47, 137 Cerebrum, 137, 138 Cesarean Section, 16, 59, 138 Chemical Warfare, 138, 142 Chemical Warfare Agents, 138, 142 Chemotaxis, 44, 138 Chemotherapeutics, 86, 138 Chin, 50, 59, 97, 138 Cholesterol, 134, 138, 156, 169, 171 Cholestyramine, 69, 138

Index 179

Chromosomal, 138, 164, 168 Chronic, 22, 70, 82, 95, 101, 129, 130, 138, 151, 153, 165, 169, 171, 173, 175 Chronic prostatitis, 70, 138 Cicatricial, 138, 151 Cilastatin, 33, 34, 51, 62, 63, 64, 138, 152 Cinchona, 138, 166 Ciprofloxacin, 7, 15, 17, 18, 22, 24, 47, 54, 138 CIS, 81, 138 Clarithromycin, 7, 11, 12, 18, 94, 117, 138 Clavulanic Acid, 96, 139 Clear cell carcinoma, 139, 143 Clindamycin, ii, iv, 1, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 69, 70, 72, 73, 74, 75, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 99, 100, 101, 102, 103, 104, 105, 112, 115, 116, 117, 118, 119, 129, 139 Clinical Medicine, 139 Clinical trial, 4, 6, 25, 45, 62, 73, 75, 111, 139, 144, 158, 167 Clone, 17, 52, 139 Cloning, 10, 135, 139 Clotrimazole, 85, 86, 139 Cloxacillin, 29, 139 Cofactor, 139, 165 Colitis, 31, 69, 71, 139 Colloidal, 64, 139, 172 Colony-Stimulating Factors, 139, 150 Colorectal, 11, 32, 139 Colorectal Surgery, 11, 32, 139 Combination chemotherapy, 69, 139 Combination Therapy, 6, 38, 139 Comedo, 96, 139 Commensal, 41, 140 Complement, 140, 149, 158, 169 Complementary and alternative medicine, 67, 72, 140 Complementary medicine, 67, 140 Computational Biology, 111, 140 Conception, 140, 141, 147, 164 Condoms, 6, 140 Conduction, 140, 159 Cone, 140, 172 Confusion, 117, 141, 144, 175 Congenita, 141, 166

Conjunctiva, 141, 153 Connective Tissue, 135, 137, 141, 147, 149, 168 Constipation, 141, 162 Consumption, 141, 143, 167 Contact dermatitis, 34, 141, 143 Contraceptive, 95, 141 Contraindications, ii, 141 Conventional therapy, 101, 141 Conventional treatment, 141 Coronary, 141, 157 Coronary Thrombosis, 141, 157 Cortex, 141, 161 Corticosteroid, 88, 141 Cortisone, 141, 143 Cost Savings, 4, 141 Cranial, 141, 142, 151 Craniocerebral Trauma, 141, 151 Cryptosporidiosis, 133, 142 Cultured cells, 16, 142 Curative, 142, 173 Curettage, 142, 168 Cutaneous, 9, 20, 22, 23, 30, 31, 35, 38, 46, 52, 55, 56, 62, 131, 141, 142, 155 Cyclic, 81, 84, 142 Cysteine, 142, 172 Cytoplasm, 134, 137, 142, 146, 150, 158, 168 D Dairy Products, 142, 169 Databases, Bibliographic, 111, 142 Decidua, 142, 163 Decontamination, 55, 142 Dementia, 129, 142 Density, 137, 142, 156 Dental Polishing, 142 Dental Prophylaxis, 46, 142 Dental Scaling, 142 Dentists, 94, 143 Dermatitis, 30, 34, 35, 88, 96, 143, 145 Dermatitis, Allergic Contact, 88, 143 Dermatologist, 23, 143 Dermatology, 21, 23, 26, 29, 31, 34, 35, 38, 39, 40, 42, 52, 55, 57, 58, 59, 62, 80, 143 DES, 143 Desensitization, 25, 143 Detergents, 143, 172 Developing Countries, 73, 85, 143 Dexamethasone, 44, 53, 143 Diabetes Mellitus, 143, 151, 162 Diabetic Foot, 57, 143 Diagnostic procedure, 77, 100, 143

180

Clindamycin

Diarrhea, 3, 17, 22, 28, 31, 35, 40, 42, 44, 52, 69, 70, 96, 130, 135, 138, 142, 143 Diarrhoea, 46, 143 Diastolic, 143, 152 Dietary Fats, 143, 155 Diffusion, 49, 135, 143, 144 Digestion, 130, 134, 135, 143, 153, 154, 155, 156, 171 Digestive system, 75, 143 Digestive tract, 87, 144 Dilate, 97, 144 Dilation, 55, 144 Dilution, 5, 144 Direct, iii, 62, 82, 101, 103, 139, 144, 149, 166, 167 Disorientation, 141, 144 Dissociation, 130, 144, 154 Dorsum, 144, 148 Dosage Forms, 91, 144 Dose-limiting, 144, 174 Double-blinded, 59, 144 Doxycycline, 18, 47, 51, 54, 96, 144 Drug Interactions, 101, 104, 116, 144 Drug Monitoring, 42, 144 Drug Tolerance, 144, 173 Duct, 24, 144, 153, 168 Duodenum, 134, 144, 171 Dura mater, 145, 157, 161 E Eczema, 88, 145 Efficacy, 4, 11, 17, 21, 31, 32, 34, 38, 39, 41, 55, 56, 62, 63, 73, 74, 80, 145, 152, 174 Elective, 32, 145 Electrolyte, 141, 145, 158, 164, 170 Electrons, 134, 145, 154, 166 Emaciation, 129, 145 Embryo, 135, 145, 164, 170 Embryo Transfer, 145, 164 Emetic, 145, 176 Emollient, 145, 150, 160 Empirical, 55, 145 Encapsulated, 36, 44, 145, 156 Encephalitis, 9, 22, 50, 74, 145, 154 Encephalitis, Viral, 145 Endemic, 145, 156 Endocarditis, 9, 11, 28, 39, 87, 145 Endocardium, 145, 146 Endophthalmitis, 30, 146 Endotoxin, 9, 28, 146, 175 Enterocolitis, 70, 146 Environmental Health, 110, 112, 146 Enzymatic, 136, 140, 146

Enzyme, 130, 139, 146, 147, 149, 150, 155, 164, 165, 167, 174, 176 Eosinophilia, 146, 147 Eosinophils, 146, 150, 155 Epidemic, 17, 52, 146 Epidemiological, 6, 146 Epidermal, 58, 70, 146 Epidermis, 146, 155, 166 Epithelial, 135, 142, 146, 162 Epithelium, 146, 148 Erythrocytes, 131, 133, 135, 146, 151, 167, 169 Esophageal, 55, 146 Esophagus, 143, 144, 146, 151, 163, 171 Excitability, 146, 166 Exfoliation, 146, 159 Exhaustion, 146, 156 Exogenous, 145, 146, 165 Exotoxin, 5, 14, 44, 96, 146 Extensor, 147, 165 Extracellular, 11, 141, 147, 170 Extraction, 39, 138, 147 F Facial, 39, 48, 63, 147 Faecal, 143, 147 Family Planning, 111, 147 Fasciitis, 96, 147 Fat, 80, 90, 134, 135, 141, 147, 155, 156, 168, 169, 170 Fatty acids, 81, 85, 147, 170 Fermentation, 147, 168 Fertilization in Vitro, 147, 164 Fetus, 95, 138, 147, 163, 170, 171, 175 Fibrillation, 60, 147 Fibrin, 135, 147, 162 Fibroblasts, 147 Fibrosarcoma, 147 Fibrosis, 130, 147, 151 Fistulas, 147, 151 Flatus, 147, 148 Fleroxacin, 7, 147 Folate, 93, 147, 148 Folic Acid, 147, 155, 174 Follicles, 78, 79, 89, 148 Foot Ulcer, 143, 148 Foramen, 138, 148, 162 Forearm, 135, 147, 148 Formulary, 4, 81, 148 Fumigation, 148 Fungi, 132, 146, 148, 157, 158, 170, 176 Fungicides, Industrial, 132, 148 Fungus, 137, 148

Index 181

G Gallbladder, 129, 134, 144, 148 Ganglion, 62, 148 Gas, 71, 131, 136, 143, 147, 148, 152, 153, 160, 172 Gas Gangrene, 71, 148 Gastric, 12, 131, 136, 144, 148, 151 Gastric Acid, 131, 148 Gastric Mucosa, 12, 148 Gastrointestinal, 55, 92, 138, 149, 156, 171 Gastrointestinal tract, 92, 149 Gelatin, 149, 172 Gels, 79, 80, 149 Gene, 5, 12, 43, 130, 135, 149, 160, 169, 174 Gene Expression, 149, 174 Genetic Engineering, 135, 139, 149 Genital, 6, 44, 138, 139, 149, 158, 168, 175 Genitourinary, 56, 58, 149, 175 Genotype, 149, 163 Germ cell tumors, 69, 149 Germ Cells, 149, 161 Gestation, 149, 163, 170 Giardiasis, 149, 157 Gland, 96, 129, 141, 149, 151, 161, 163, 165, 169 Glomerular, 149, 167 Glomeruli, 149, 166 Glucocorticoid, 143, 149 Glucose, 82, 84, 143, 149, 151, 169 Glutathione Peroxidase, 149, 169 Glycerol, 5, 149 Glycoprotein, 150, 175 Glycosidic, 150, 160 Gonadal, 150, 171 Gonorrhea, 137, 150 Governing Board, 150, 164 Grade, 81, 150 Graft, 150, 152, 153 Gram-negative, 10, 11, 13, 15, 18, 69, 83, 87, 133, 134, 137, 150, 152, 159, 160, 165, 173 Gram-Negative Anaerobic Bacteria, 15, 150 Gram-Negative Bacteria, 69, 150, 173 Gram-positive, 13, 15, 17, 87, 90, 91, 133, 137, 150, 152, 155, 160, 162, 170, 171, 173 Gram-Positive Bacteria, 13, 90, 91, 150, 160, 173 Gram-Positive Bacterial Infections, 91, 150 Granule, 150, 168 Granulocyte Colony-Stimulating Factor, 38, 139, 150

Granulocytes, 27, 139, 150, 176 Groin, 150, 151 Growth, 11, 14, 68, 131, 132, 134, 137, 143, 147, 148, 150, 156, 159, 163, 174, 175 Gyrase, 147, 150 H Haemophilus, 137, 150 Hair follicles, 96, 151 Half-Life, 86, 137, 151 Headache, 117, 151, 153 Headache Disorders, 151 Heartburn, 135, 151, 153 Hematologic Diseases, 38, 151 Hematology, 31, 63, 151 Hemoglobin, 131, 146, 151 Hemolysis, 133, 151 Hemolytic, 13, 43, 147, 151 Hemorrhage, 142, 151, 171 Hepatic, 68, 151 Heredity, 129, 149, 151 Hidradenitis, 57, 151 Hidradenitis Suppurativa, 57, 151 Homologous, 130, 152, 169 Hormonal, 90, 141, 151, 152 Hormone, 141, 143, 152, 164, 168 Host, 94, 133, 140, 152, 153, 168, 172, 175, 176 Hybrid, 139, 152 Hydrogel, 70, 152 Hydrogen, 131, 134, 136, 149, 152, 158 Hydrolysis, 134, 152, 164 Hydrophilic, 143, 152, 172 Hyperbaric, 68, 71, 152 Hyperbaric oxygen, 68, 71, 152 Hypersensitivity, 26, 42, 130, 143, 152, 168, 169, 170 Hypertension, 82, 151, 152 Hypotension, 96, 152 Hysterotomy, 138, 152 I Id, 65, 71, 117, 124, 126, 152 Idiopathic, 151, 152 Imidazole, 139, 152 Imipenem, 7, 33, 34, 51, 62, 63, 64, 138, 152 Immune response, 131, 132, 141, 152, 153, 158, 169, 171, 175, 176 Immune system, 117, 152, 153, 156, 175, 176 Immunity, 82, 129, 153, 156, 170, 174 Immunodeficiency, 6, 83, 116, 117, 129, 153 Immunodeficiency syndrome, 153

182

Clindamycin

Immunotherapy, 143, 153 Impaction, 142, 153 Impairment, 134, 153, 157 In situ, 88, 95, 153 In vitro, 7, 8, 9, 11, 12, 13, 14, 27, 40, 43, 45, 55, 56, 64, 69, 86, 145, 153, 168, 172 In vivo, 7, 13, 14, 32, 43, 44, 55, 82, 86, 153 Incision, 152, 153, 154 Incubated, 12, 153 Indicative, 94, 153, 161, 176 Indigestion, 135, 153 Infarction, 141, 153, 157 Influenza, 96, 153 Infusion, 16, 47, 153, 174 Ingestion, 86, 131, 153 Inhalation, 5, 73, 129, 153 Inner ear, 137, 154, 157, 176 Inoculum, 96, 154 Interleukin-1, 9, 28, 154 Interleukin-2, 154 Internal Medicine, 3, 34, 35, 42, 46, 64, 83, 151, 154 Interstitial, 154, 167 Intestinal, 11, 67, 68, 134, 142, 146, 154, 155 Intestine, 134, 135, 144, 149, 152, 154, 155, 171 Intracellular, 10, 11, 27, 153, 154, 164, 169 Intramuscular, 47, 86, 154, 161 Intramuscular injection, 86, 154 Intraocular, 53, 146, 154 Intraperitoneal, 47, 154 Intravenous, 16, 20, 31, 47, 96, 153, 154, 161 Invasive, 28, 42, 153, 154 Involuntary, 147, 154, 159 Ionization, 52, 154 Ions, 134, 138, 144, 145, 152, 154 Isotretinoin, 97, 154 Ixodes, 133, 154 J Joint, 138, 154, 172 K Kanamycin, 131, 154 Kb, 110, 154 Keratin, 139, 155, 169 Kinetics, 13, 43, 155 L Lactation, 59, 155 Lactobacillus, 55, 62, 64, 155 Laparoscopy, 16, 155 Large Intestine, 144, 154, 155, 167 Leishmaniasis, 155, 162

Lethal, 133, 155 Leucovorin, 74, 117, 155 Leukocytes, 134, 135, 146, 150, 155, 158, 175 Levofloxacin, 22, 155 Library Services, 124, 155 Lidocaine, 134, 155 Lincomycin, 11, 15, 78, 80, 81, 82, 84, 86, 88, 90, 139, 155 Lip, 30, 155 Lipase, 11, 155 Lipid, 82, 89, 149, 155, 156 Lipophilic, 155, 172 Lipopolysaccharide, 9, 150, 155 Lipoprotein, 150, 156 Liposomal, 89, 90, 156 Liposome, 36, 156 Litter, 117, 156 Liver, 24, 84, 129, 134, 144, 148, 151, 156 Localized, 129, 145, 153, 156, 161, 163, 169, 175 Lymphatic, 153, 156 Lymphocyte, 129, 132, 156 Lymphocyte Count, 129, 156 Lymphokines, 96, 156 M Macrolides, 7, 10, 12, 13, 17, 23, 36, 43, 45, 59, 156 Macrophage, 139, 154, 156 Malaria, 10, 17, 18, 26, 34, 35, 51, 53, 56, 63, 64, 83, 84, 138, 156 Malaria, Falciparum, 156 Malaria, Vivax, 156 Malignant, 69, 129, 132, 147, 149, 156, 159 Mandible, 138, 156, 167 Manifest, 96, 156 Meat, 143, 157, 169 Medial, 157, 168 Medical Records, 157, 168 Medical Staff, 144, 157 Medicament, 90, 157, 172 MEDLINE, 111, 157 Membrane, 15, 80, 137, 139, 140, 141, 146, 150, 157, 158, 159, 160, 162, 166, 167, 174 Meninges, 133, 137, 142, 145, 157 Meningitis, 9, 28, 157 Mental Disorders, 76, 157 Meta-Analysis, 32, 157 Metabolite, 16, 47, 155, 157 Methionine, 157, 172 Mezlocillin, 15, 157

Index 183

MI, 80, 81, 84, 85, 87, 88, 89, 90, 91, 127, 157 Microbe, 157, 173, 174 Microbiological, 6, 157 Microbiology, 20, 22, 27, 28, 31, 34, 36, 45, 46, 49, 52, 60, 62, 63, 68, 69, 70, 94, 133, 134, 157 Microorganism, 139, 157, 161, 176 Micro-organism, 158, 163 Microscopy, 82, 158, 160 Microsporidiosis, 46, 158 Migration, 158, 162 Mineralocorticoids, 129, 141, 158 Minocycline, 85, 89, 96, 158 Miocamycin, 41, 53, 158 Miscarriage, 37, 158 Molecular, 3, 5, 15, 62, 111, 113, 131, 135, 140, 158, 175 Molecule, 132, 134, 140, 144, 150, 152, 158, 164, 167, 172, 174 Monocytes, 96, 154, 155, 158 Monokines, 96, 158 Mononuclear, 147, 158, 175 Monophosphate, 87, 158 Morphology, 151, 158 Moxalactam, 10, 16, 158 Mucinous, 148, 158 Mucosa, 146, 148, 158 Mucus, 158, 175 Multicenter study, 20, 59, 158 Muscle Relaxation, 158, 159 Myalgia, 96, 153, 159 Mycoplasma, 6, 137, 159 Mydriatic, 144, 159 Myocardium, 157, 159 Myotonia, 159, 166 N Nasal Mucosa, 153, 159 Nausea, 135, 144, 153, 159, 175 NCI, 1, 75, 109, 138, 159 Nebramycin, 159, 173 Necrolysis, 58, 70, 159 Necrosis, 146, 147, 153, 157, 159 Need, 3, 87, 93, 94, 95, 101, 105, 118, 129, 159, 173 Neoplasms, 129, 132, 159, 174 Neoplastic, 159, 168 Nerve, 129, 131, 138, 148, 159, 161, 167 Nervous System, 137, 159, 171 Neuromuscular, 25, 30, 46, 49, 63, 67, 159 Neuromuscular Blockade, 30, 49, 63, 67, 159

Neuromuscular Junction, 159 Neurotransmitters, 158, 160 Neutropenia, 46, 69, 84, 160 Neutrophil, 10, 160 Nitrogen, 130, 131, 160 Nosocomial, 3, 35, 46, 160 Nuclear, 134, 145, 148, 159, 160 Nucleolus, 160, 168 Nucleus, 134, 142, 146, 158, 160 O Ocular, 14, 53, 64, 160 Ofloxacin, 11, 22, 160 Ointments, 85, 88, 144, 160, 170, 176 Oligosaccharides, 69, 160 Operon, 160, 167 Opportunistic Infections, 129, 160 Organelles, 137, 142, 158, 160 Ornidazole, 16, 160 Orofacial, 94, 160 Osteomyelitis, 9, 17, 19, 60, 87, 95, 160 Ototoxic, 131, 161 Outpatient, 161 Ovary, 69, 161 Oxacillin, 139, 161 P Pachymeningitis, 157, 161 Palliative, 161, 173 Palmitates, 81, 84, 161 Palmitic Acid, 161 Pancreas, 129, 144, 155, 161 Parasite, 84, 117, 161, 174 Parenteral, 46, 70, 74, 85, 86, 161 Particle, 156, 161 Patch, 70, 161 Pathogen, 154, 161, 172 Pathogenesis, 5, 6, 151, 161 Pathologic, 141, 152, 161, 165, 167 Pathophysiology, 93, 161 Patient Education, 116, 122, 124, 127, 161 Patient Satisfaction, 49, 161 Pelvic, 6, 16, 18, 20, 47, 48, 51, 54, 63, 72, 161, 165 Pelvic inflammatory disease, 6, 18, 47, 51, 54, 161 Penicillin, 9, 13, 14, 18, 21, 26, 27, 28, 43, 44, 45, 47, 94, 96, 131, 136, 157, 161, 162, 163, 173 Penicillin V, 21, 162 Penicillinase, 11, 136, 162 Penis, 140, 162 Pentamidine, 84, 93, 116, 162 Peptide, 139, 155, 162, 164, 165, 172

184

Clindamycin

Peptide Chain Elongation, 139, 162 Perfusion, 162, 173 Pericoronitis, 95, 162 Periodontal disease, 95, 142, 162 Periodontal Pocket, 55, 142, 162 Periodontitis, 95, 101, 162 Perioral, 96, 162 Peritoneal, 9, 16, 154, 162 Peritoneal Cavity, 154, 162 Peritoneum, 162 Peritonitis, 62, 162 Peroxide, 20, 34, 55, 58, 78, 79, 89, 134, 149, 162 Phagocytosis, 27, 162 Pharmaceutical Solutions, 144, 162 Pharmacist, 31, 163 Pharmacokinetic, 8, 16, 24, 69, 163 Pharmacologic, 131, 151, 163, 173, 174 Pharyngitis, 4, 20, 163 Pharynx, 153, 163 Phenotype, 41, 53, 163 Phosphates, 81, 82, 84, 163 Phosphorus, 87, 136, 163 Photoreceptors, 163 Physiologic, 135, 151, 163, 167 Physiology, 36, 151, 163, 172 Pigments, 9, 163 Pilot study, 58, 163 Piperacillin, 18, 48, 163 Piperacillin-tazobactam, 18, 163 Pituitary Gland, 141, 163 Placenta, 48, 63, 95, 163, 164 Plants, 130, 135, 136, 149, 158, 163, 165, 169, 171, 174 Plaque, 67, 95, 101, 142, 163 Plasma, 36, 42, 50, 86, 132, 137, 139, 149, 151, 158, 159, 160, 163, 173 Plasmid, 8, 10, 12, 15, 164 Polymerase, 164, 167 Polymorphic, 91, 164 Polypeptide, 90, 164 Postoperative, 59, 164 Potassium, 158, 164, 166, 170 Potentiates, 154, 164 Potentiation, 44, 164 Practice Guidelines, 112, 164 Precursor, 81, 146, 150, 164 Pregnancy Outcome, 37, 164 Prevalence, 4, 41, 42, 53, 164 Progesterone, 164, 171 Progressive, 96, 142, 144, 150, 159, 164, 167, 175

Promyelocytic leukemia, 164, 174 Prophylaxis, 7, 8, 11, 28, 29, 30, 39, 57, 87, 95, 164, 175 Prospective Studies, 6, 164 Prospective study, 29, 69, 165 Prostate, 138, 165 Prostate gland, 138, 165 Prostatitis, 165 Protease, 139, 165 Protein Binding, 165, 173 Protein S, 10, 78, 86, 135, 139, 146, 165, 168, 173 Proteins, 82, 131, 132, 137, 140, 146, 154, 155, 158, 160, 162, 163, 165, 169, 172, 174 Protozoa, 86, 155, 157, 158, 165, 170, 174 Proximal, 142, 165 Pruritic, 145, 165 Pseudomembranous Colitis, 25, 41, 165 Pseudomonas, 9, 14, 136, 137, 163, 165, 173 Pseudomonas Infections, 163, 165 Psoriasis, 88, 165, 174 Puberty, 78, 90, 165 Public Policy, 111, 165 Publishing, 7, 94, 95, 165 Pulmonary, 135, 141, 166, 176 Pulmonary Artery, 135, 166, 176 Pulse, 91, 92, 166 Pupil, 144, 159, 166 Purulent, 35, 146, 166, 175 Pustular, 129, 166 Pyelonephritis, 83, 166 Pyogenic, 160, 166 Pyrogenic, 14, 44, 47, 96, 166 Q Quinidine, 48, 63, 138, 166 Quinine, 10, 17, 18, 26, 34, 41, 51, 56, 63, 64, 138, 166 Quinolones, 8, 14, 16, 59, 166 R Radiation, 152, 157, 160, 166, 168 Radiation therapy, 152, 166, 168 Radioactive, 142, 151, 152, 154, 160, 166 Ramus, 50, 166 Randomized, 8, 17, 21, 29, 30, 34, 37, 38, 39, 45, 47, 49, 50, 51, 52, 60, 62, 63, 64, 145, 167 Reactivation, 11, 167 Reagent, 88, 167 Receptor, 132, 140, 167, 172 Recombinant, 38, 167 Rectal, 90, 167

Index 185

Rectum, 49, 131, 132, 135, 139, 144, 147, 148, 155, 165, 167, 172 Recurrence, 6, 49, 74, 167 Red blood cells, 146, 151, 167, 169 Reductase, 167, 174 Refer, 1, 140, 148, 160, 167 Refraction, 167, 170 Regimen, 53, 64, 145, 167, 168 Remission, 167 Renal failure, 84, 167 Renal pelvis, 83, 167 Repressor, 6, 160, 167 Reproduction Techniques, 164, 167 Resorption, 162, 167 Respiration, 136, 167 Restoration, 167 Retina, 167, 168 Retinoid, 89, 168 Retreatment, 16, 168 Retrospective, 49, 168 Retrospective study, 49, 168 Retrovirus, 83, 168 Rheumatism, 168 Rheumatoid, 82, 168 Rheumatoid arthritis, 82, 168 Ribosome, 86, 168, 174 Rifamycins, 23, 168 Risk factor, 165, 168 Ristocetin, 168, 176 Rod, 133, 134, 150, 155, 165, 168 Root Planing, 95, 101, 168 Roxithromycin, 9, 12, 13, 18, 168 S Sagittal, 50, 168 Salivary, 143, 168 Salivary glands, 143, 168 Salvage Therapy, 100, 168 Saponins, 169, 171 Saturated fat, 81, 161, 169 Scalpel, 97, 169 Scleroderma, 147, 169 Screening, 82, 139, 169 Sebaceous, 78, 79, 85, 89, 90, 96, 169 Sebaceous gland, 78, 79, 85, 89, 90, 96, 169 Sebum, 90, 96, 129, 139, 169 Secretion, 129, 141, 155, 158, 169 Sediment, 82, 169 Segregation, 134, 169 Selenium, 85, 169 Semisynthetic, 131, 136, 137, 138, 139, 152, 157, 158, 163, 168, 169 Sensitization, 143, 169

Sequencing, 5, 169 Serum, 10, 16, 24, 42, 46, 52, 84, 131, 136, 140, 158, 162, 169, 175 Sex Characteristics, 131, 165, 169 Sexually Transmitted Diseases, 6, 33, 169 Shock, 16, 27, 96, 169, 174 Side effect, 74, 78, 85, 95, 97, 101, 103, 105, 116, 129, 144, 170, 174 Signs and Symptoms, 96, 167, 170 Skeletal, 131, 166, 170 Skin Tests, 35, 170 Soaps, 170, 172 Sodium, 80, 84, 158, 166, 170, 172 Soft tissue, 87, 96, 135, 136, 147, 148, 170 Solvent, 87, 150, 162, 170 Specialist, 118, 144, 170 Specificity, 130, 170, 173 Spectrum, 79, 87, 92, 94, 139, 147, 152, 158, 168, 170, 172 Sperm, 131, 149, 170 Spinal cord, 137, 138, 145, 148, 157, 159, 161, 170 Spiramycin, 10, 33, 96, 170 Spontaneous Abortion, 164, 170 Spores, 154, 170 Standard therapy, 74, 171 Staphylococcus, 5, 8, 9, 11, 12, 13, 14, 17, 19, 23, 28, 32, 36, 40, 49, 51, 60, 82, 139, 158, 171 Steroid, 53, 64, 88, 134, 141, 169, 171 Stillbirth, 164, 171 Stomach, 46, 86, 129, 143, 144, 146, 148, 149, 152, 159, 162, 163, 171 Streptococcal, 4, 11, 13, 14, 20, 26, 27, 40, 43, 44, 96, 116, 155, 171 Streptococcal Infections, 4, 116, 171 Streptococci, 4, 41, 47, 79, 86, 87, 171 Stress, 159, 168, 171 Stroke, 76, 110, 171 Styptic, 171, 176 Subacute, 153, 171 Subarachnoid, 151, 171 Subclinical, 153, 171 Subcutaneous, 137, 161, 171 Subspecies, 170, 171 Substance P, 146, 157, 168, 169, 171 Sulbactam, 7, 22, 33, 37, 51, 59, 171 Sulfadiazine, 15, 22, 50, 53, 59, 74, 117, 172 Sulfadoxine, 15, 53, 172 Sulfur, 78, 85, 86, 97, 157, 172 Superantigens, 5, 96, 172 Superinfection, 133, 172

186

Clindamycin

Suppositories, 88, 149, 172 Suppression, 32, 141, 172 Suppressive, 84, 172 Suppurative, 137, 146, 151, 172 Surface-Active Agents, 5, 172 Suspensions, 88, 172 Sweat, 132, 151, 172 Symphysis, 138, 165, 172 Symptomatic, 3, 4, 6, 88, 172 Systemic, 53, 54, 57, 78, 79, 82, 84, 85, 95, 101, 104, 135, 153, 166, 169, 172, 174 Systolic, 152, 172 T Tachycardia, 133, 172 Tachypnea, 133, 172 Teichoic Acids, 150, 173 Teicoplanin, 39, 173 Teratogenic, 130, 154, 173, 174 Tetracycline, 8, 11, 14, 15, 17, 18, 19, 54, 57, 59, 80, 85, 89, 94, 95, 101, 144, 158, 173 Tetracycline Resistance, 8, 15, 17, 173 Therapeutics, 20, 21, 49, 104, 173 Threshold, 146, 152, 173 Thrombocytopenia, 84, 173 Thrombosis, 165, 171, 173 Ticarcillin, 10, 39, 57, 173 Tick-Borne Diseases, 133, 173 Tinidazole, 39, 86, 173 Tissue Distribution, 83, 173 Tobramycin, 11, 17, 34, 45, 52, 62, 64, 72, 173 Tolerance, 73, 173 Tonsillitis, 20, 173 Tonsils, 173 Toxic, iv, 27, 58, 70, 74, 96, 130, 138, 146, 153, 162, 169, 174, 176 Toxicity, 22, 58, 74, 144, 168, 174 Toxicology, 112, 174 Toxins, 45, 132, 135, 145, 153, 174 Toxoplasmosis, 15, 18, 19, 20, 53, 64, 74, 117, 133, 172, 174 Transcriptase, 168, 174 Transfection, 135, 174 Transfer Factor, 8, 174 Transfusion, 41, 63, 174 Translation, 146, 174 Translocation, 11, 90, 139, 146, 174 Trauma, 54, 68, 71, 159, 174, 176 Tretinoin, 21, 31, 39, 42, 58, 62, 63, 65, 89, 174 Trichomonas, 160, 173, 174 Trichomonas Infections, 160, 174

Trichomoniasis, 157, 174 Trimethoprim-sulfamethoxazole, 23, 24, 29, 30, 34, 116, 117, 174 Trimetrexate, 116, 174 Trypanosomiasis, 162, 174 Tumor Necrosis Factor, 9, 28, 175 Tumour, 148, 175 U Ulcer, 137, 175 Ulcerative colitis, 68, 175 Unconscious, 152, 175 Uracil, 20, 175 Uremia, 167, 175 Ureter, 167, 175 Urethra, 162, 165, 175 Urinary, 6, 80, 83, 134, 136, 137, 138, 149, 172, 175 Urinary tract, 6, 80, 83, 134, 136, 137, 172, 175 Urinary tract infection, 6, 80, 83, 134, 136, 175 Urine, 82, 86, 134, 135, 136, 139, 167, 175 Urogenital, 80, 134, 149, 150, 175 Urogenital Diseases, 80, 175 Uterus, 142, 152, 164, 175 Uvea, 146, 175 V Vaccination, 38, 175 Vaccine, 4, 175 Vagina, 86, 143, 152, 155, 175 Vaginal, 6, 21, 23, 24, 31, 33, 37, 38, 39, 41, 49, 50, 55, 58, 59, 60, 80, 85, 86, 104, 175, 176 Vaginal Discharge, 6, 55, 175 Vaginitis, 35, 95, 175 Vaginosis, 6, 21, 23, 33, 37, 38, 39, 44, 45, 48, 49, 52, 56, 58, 60, 80, 86, 100, 176 Vancomycin, 14, 71, 176 Vascular, 130, 143, 151, 153, 163, 176 Vein, 154, 160, 176 Venous, 165, 176 Ventricle, 166, 172, 176 Venules, 135, 176 Verapamil, 22, 32, 176 Veterinary Medicine, 111, 176 Viral, 145, 153, 168, 173, 176 Virulence, 5, 133, 172, 174, 176 Virus, 6, 83, 116, 117, 129, 133, 137, 149, 163, 176 Vitro, 12, 13, 45, 176 Vivo, 13, 52, 176

Index 187

W Wetting Agents, 172, 176 White blood cell, 132, 153, 155, 156, 158, 160, 176 Wound Infection, 95, 176

Y Yeasts, 148, 163, 176 Z Zinc Acetate, 79, 176 Zinc Oxide, 176 Zoonoses, 133, 176

188

Clindamycin