Purpose: Combination of benzoyl peroxide (BPO) with topical antibiotics can lead to higher efficacy and less bacterial resistance, but it in turn increases adverse effects such as skin irritability and dryness. In this study, the efficacy of combination therapy of niosomal BPO 1% and clindamycin (CL) 1% is compared with niosomal CL in acne vulgaris. Methods: This is a double-blind clinical trial study on 100 patients with acne vulgaris in Afzalipour hospital in Kerman. Patients were randomly divided into 2 groups (case and control). The case group received niosomal combination of BPO 1% and CL 1%. The control group received niosomal CL1%. The efficacy of treatment protocols was evaluated in 2nd, 4th, 8th and 12th weeks of treatment by counting lesions (severity and grading acne lesions) and quality of life (QoL). Furthermore, side effect were evaluated at each treatment visits. Results: The reduction in mean percentage of acne lesions in case group (treated with BPO 1% and CL1%) (64. 21%) was higher than control group (treated with niosomal CL 1%) (59. 04%), but the statistical difference was not significant. Sum of excellent and good results were found in 80% and 76. 1% of case and control groups, respectively (P = 0. 377). Also adding BPO to the treatment formulation in case group did not increase adverse effects, as statistical difference between 2 groups was not significant. Conclusion: Combination of niosomal BPO 1% and CL 1% in treatment of acne vulgaris showed higher efficacy with no increase in adverse effects in comparison with niosomal CL 1%, but the statistical difference was not significant.

Clindamycin is a lincosamide antibiotic which is approved for the treatment of Anaerobic, Streptococcal and Staphylococcal infections. There has been an increased interest in the use of clindamycin since it achieves high intracellular levels in phagocytic cells, high levels in bone and appears to have an antitoxin effect against the toxin elaborating strains of streptococci and staphylococci. Clindamycin is considered as a bacteriostatic antibiotic, while it is bactericidal against some strains of Staphylococci, Streptococci and Anaerobes such as B. fragilis. Its major disadvantage is its propensity to cause antibiotic-associated diarrhea. In spite of expanded use of clindamycin in bone infections, the adverse reactions of this antibiotic are minor. Polyarthritis is a rare adverse effect of this antibiotic.In this case report, we studied a 75-year-old male patient with past history of drop attack and subdural hematoma who developed skull osteomyelitis after the surgery. After two weeks of intravenous antibiotic therapy, wound discharge was stopped and the patient was discharged from the hospital with the maintenance oral antibiotic therapy including clindamycin 300 mg q8 h, ciprofloxacin 500 mg q12 h and rifampin 600 mg fasting.Six days after the beginning of oral antibiotics, right wrist monoarthritis was developed. It was unresponsive to nonsteroidal anti-inflammatory drug and improved after decreased doses of clindamycin. As best as we know, monoarthritis was not reported with clindamycin previously.

Contaminants of emerging concern or simply emerging contaminants have been considered as a critical environmental issue in recent decades. These compounds have not routinely controlled and monitored; therefore they have posed risk to the health of human and environment. Drugs are considered as one of the most important emerging pollutants. They introduce to environment form different sources such as urine, human excretion, livestock, poultry, pharmaceutical, and hospitals. Although they are in trace levels, they are not biodegradable. They cannot be removed by conventional treatment processes. Advanced oxidation processes (AOPs) have been designed to address the deficiency of conventional methods in the removal of emerging pollutants. Production of highly reactive hydroxyl radicals is the base of AOPs. These very reactive radicals effectively oxidize emerging pollutants such as drugs. Among different approach of AOPs, photocatalytic degradation has been successfully applied to mitigate the side effects of emerging contaminants. The ability of the photocatalytic process in the removal of Clindamycin hydrochloride (CLM) from aqueous solutions in the presence of UV/TiO2 was studied. The effects of various parameters such as adsorption, photolysis, pH, catalyst dosage, initial concentration of antibiotic, and radiation time were investigated in a batch photoreactor. Results showed that photolysis and adsorption had a negligible contribution to the clindamycin removal. The maximum clindamycin removal rate was obtained under optimal conditions, such as pH of 5, 0. 5 g/l of TiO2, initial clindamycin concentration of 2 /L. This optimum condition was achieved for 90 minutes. The CLM photocatalytic degradation kinetics showed that CLM degradation follows the pseudo-first-order kinetics.

Background: Streptococcus group B (GBS) or Streptococcus agalactiae is typically associated with neonatal disease and infection in pregnant women. Mortality of GBS sepsis in neonates is over 50% and is particularly high in preterm infants. GBS also causes invasive infection in pregnant and non-pregnant women including urinary tract infection (UTI). Penicillin-derived antibiotics remained as choice drugs for treatment of GBS infection; however, Erythromycin and Clindamycin are useful in cases of allergic to Penicillin. The aim of this study was to investigate the resistance to Erythromycin and Clindamycin, especially inducible Clindamycin resistance, in GBS isolated from urinary samples of women who attended medical offices in Tehran, Iran.Materials and Methods: This study was conducted on 5000 urine samples from Jan.2011 to Oct.2012 that 104 GBS were isolated. The isolates were identified as GBS using laboratory criteria. Antimicrobial susceptibility test was done by Erythromycin disk 15μg and Clindamycin disk 2μg for observation inducible resistant D-zone test by double-disk diffusion method with Erythromycin and adjacent Clindamycin.Results: Among the 5000 urine samples 104 (2.08%) were Beta hemolytic GBS. Of the 104 isolated GBS, 22 (21.2%) were resistance, 24 (23%) were intermediate, and 58 (55.8%) were susceptible to Erythromycin; however, 24 (23%) were resistance, 5 (4.8%) were intermediate, and 75 (72.2%) were susceptible to Clindamycin. Of the 22 Erythromycin-resistant isolates, 10 (9.5% in total GBS isolated) displayed the D zone; it means they have inducible Erythromycin resistant to Clindamycin.Conclusion: Various studies in other countries report lower rates of inducible Clindamycin resistance; it indicates the use of more macrolides in the treatment of UTI.