Clindamycin is not adequate for empiric therapy for Staphylococcal infections due to increased resistance. Given its association with C difficile colitis, its use should be limited to severe group A Strep sepsis.

Gram positive

•  MSSA

•  Susceptible MRSA (~2/3 of isolates at Billings Clinic)

•  Group A,B,C,G Streptococci (but increasing resistance)

•  Viridans Streptococci

Gram negatives

•  Essentially no aerobic gram negative coverage

Anaerobes

•  Increasing resistance in Bacteroides fragilis (do not use for gut anaerobes)

•  Covers many oral anaerobes

Other

•  Pneumocyctis jiroveci

•  Malaria

•  Toxoplasma

Does not cover

•  Almost all aerobic gram negatives

•  Enterococci