Clindamycin

Which of the following is an appropriate dose adjustment for a patient with a creatinine clearance of 30 mL/min receiving oral clindamycin? *

No dose adjustment necessary Add a proton‑pump inhibitor to the regimen Increase the dose to 600 mg q6h Reduce the dose to 300 mg q6h Switch to intravenous formulation

What is the primary mechanism by which bacteria develop resistance to clindamycin? *

Production of β‑lactamases Modification of the lipopolysaccharide layer Decreased permeability of the cell wall Efflux pumps that expel the drug Methylation of the 23S rRNA component of the 50S ribosomal subunit

In pregnancy, clindamycin is classified as: *

Category B Category D Category C Category A Category X

Which of the following infections is a classic indication for clindamycin therapy? *

Lemierre’s syndrome caused by *Fusobacterium necrophorum* Urinary tract infection caused by *Proteus mirabilis* Community‑acquired pneumonia caused by *Streptococcus pneumoniae* Acute bacterial sinusitis caused by *Haemophilus influenzae* Meningitis caused by *Neisseria meningitidis*

How is clindamycin best absorbed when given orally? *

It requires a proton‑pump inhibitor to increase absorption. It is best absorbed on an empty stomach. It is poorly absorbed orally and must be given intravenously. It is best absorbed with a high‑fat meal. It is best absorbed when taken with antacids.

Which of the following is the most common serious adverse effect associated with clindamycin therapy? *

Agranulocytosis Ototoxicity Clostridioides difficile colitis Pulmonary fibrosis Severe hyperglycemia

What is the primary mechanism of action of clindamycin? *

Interference with folic acid metabolism Inhibition of bacterial protein synthesis by binding to the 50S ribosomal subunit Disruption of cell wall synthesis Inhibition of DNA gyrase Depolymerization of bacterial peptidoglycan

Which of the following organisms is *not* typically susceptible to clindamycin? *

*Escherichia coli* (Enterobacteriaceae) *Streptococcus pyogenes* *Peptostreptococcus* spp. *Clostridioides difficile* *Staphylococcus aureus* (methicillin‑sensitive)

In which patient population should clindamycin dosing be reduced or monitored closely? *

Elderly patients (>80 yrs) Children <1 yr of age Patients with hepatic impairment Patients with renal impairment Pregnant women (first trimester)

Which of the following statements is true regarding clindamycin’s interaction with warfarin? *

Clindamycin decreases warfarin effectiveness, necessitating dose increase. Clindamycin has no clinically significant interaction with warfarin. Clindamycin induces CYP2C9, enhancing warfarin metabolism. Clindamycin is contraindicated in patients on warfarin. Clindamycin increases warfarin potency, requiring dose reduction.

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