Clear Gel is a topical antibiotic containing Clindamycin which is a potent bacteriostatic agent. It is listed in the World Health Organisation’s (WHO) list of essential medicines which include only the safest and most effective medicines for human use. The clear gel has been found to be effective in alleviating symptoms of various skin conditions.
Uses and benefits of Clear Gel:
Clear gel ointment is used to treat many bacterial skin infections. It is effective against numerous bacteria such as Propionibacterium acnes, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pneumoniae.
- Acne: Acne is a skin condition that occurs mostly in adolescents and young adults due to the blocking of hair follicles by dead skin cells and oil from the skin. Symptoms include the appearance of blackheads, whiteheads, pimples, oily skin and scarring of healed pustules. The pimples may get infected secondarily due to ill hygiene and may form boils or pustules. Topical antibiotics form the mainstay of treatment. Clindamycin 1% preparation as it is frequently used to treat acne and other skin rashes.
- Staphylococcal skin infections: Staphylococcus species causes infections of the skin such as folliculitis or inflammation of hair follicles, furuncles or boils, impetigo, ecthyma, cellulitis, secondary skin infections of wounds, dermatitis or inflammation of the skin, scabies, diabetic ulcers and burn wounds, etc. These infections are more common in elderly and debilitated patients with immunocompromised states such as Diabetes mellitus. Cleargel has been shown to be quite effectual against certain staphylococcal skin infections such as cellulitis, furuncles, folliculitis, boils and wound infections.
- Others: In women with bacterial vaginosis, clindamycin gel or lotion have been used successfully. Bacterial vaginosis is caused by a shift in normal vaginal flora where coccobacilli start colonising the vaginal tract overpowering the normally encountered Doderlain’s bacilli or lactobacilli. This results in increased vaginal discharge, inflammation and itching. Clindamycin has consistently shown good results on continued use.
Clindamycin is also effective in treating skin and soft tissue infections due to Methicillin-resistant Staphylococcus aureus organisms (MRSA). These are usually resistant to treatment with the conventional first-line therapy with penicillins and hence aggressive second-line treatment with other agents such as clindamycin is usually sought after.
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Side Effects of Clear Gel:
Clear gel with Clindamycin is usually tolerated well with hardly any side effects. Very rarely in susceptible individuals, the following side-effects may occur:
- Skin irritation
- Easy bruising
- Skin rashes
- Body ache
- Oily skin
- Burning sensation in eyes
- Irritation of eyes
- Abdominal pain
- Folliculitis or inflammation of the skin and soft tissue around hair follicles
- Contact dermatitis
- Abdominal cramps
- Scaliness or peeling of skin
Rarely allergic or anaphylactic reactions characterised by sudden difficulty to breathe, dyspnoea, fever, skin rashes, swelling of face, lips, face, etc may occur. In such cases, the patient should be given immediate emergency care by a certified medical practitioner.
Clindamycin is known to cause a potentially lethal condition called pseudomembranous colitis where there is the overgrowth of Clostridium difficile that is resistant to clindamycin. The bacterium produces an excess of toxins which when released into the gastrointestinal system produce adverse effects such as diarrhoea due to colitis and toxic megacolon. This condition is more commonly encountered with oral intake of Clindamycin and is rarely reported on topical use.
If the patient experiences sudden watery or bloody diarrhoea, then the reporting physician should be consulted immediately for ruling out the possibility of pseudomembrane colitis.
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Common Dosage of Clear Gel:
Clear gel topical ointment is for external use on the skin only and should not be ingested or applied to mucous membranes. The affected area should be clean and dry before applying a thin layer of the gel. The gel has to be applied once every 12 hours or more as advised by a registered medical practitioner. The dose depends on the duration of symptoms, severity of disease and other factors.
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Composition and Nature of Clear Gel:
Clear Gel is an ointment preparation of 1%w/w Clindamycin which is a topically active anti-bacterial agent. Clindamycin is derived semi-synthetically from Lincomycin, which is a natural antibiotic produced by actinobacterium Streptomyces lincolnensis. The ointment which is prepared for topical application is a phosphate ester prodrug of Clindamycin.
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How Clear Gel Works?
Mechanism of Action of Clear Gel (Clindamycin 1%w/w)
Clear gel’s active ingredient, Clindamycin works by inhibiting protein synthesis in bacterial cells. It is a bacteriostatic similar to the macrolides class of drugs and interferes with ribosomal translocation. Clindamycin binds to the 50s subunit of ribosomal RNA and interferes with bacterial protein synthesis.
Warnings and Precautions – When to Avoid Clear Gel?
The topical preparation of Clindamycin as Clear Gel is best avoided in the following circumstances:
- If the patient is known to have an allergy or a previous anaphylactic reaction to lincosamide group of drugs to which Clindamycin belongs.
- If the patient is suffering from long-standing asthma, Liver disorders or inflammatory bowel diseases such as Crohn’s disease.
- If the patient is suffering from gastrointestinal disorders.
Clear Gel can be safely used to treat skin infections in Pregnant women.
Though Clindamycin is considered safe for use in Lactating mothers by the American Academy of Paediatrics, the World Health Organisation recommends avoiding the drug if possible during lactation.
Since the macrolide class of antibiotics and clindamycin share similar mechanisms of action, it is better to avoid administering both simultaneously due to the risk of antagonism and cross-resistance.
Clindamycin causes prolongation of the effects of neuromuscular blocking agents such as succinylcholine and vecuronium.
It does not interact with alcohol.
It does not cause renal or hepatic impairment and hence can be used safely in patients with renal or hepatic insufficiency.
Clindamycin interferes with pharmacodynamics of birth control pills which may lose their efficacy if taken along with ClearGel. A secondary birth control measure is generally recommended.
The clear gel may cause or aggravate eczematous skin reactions in susceptible individuals. Hence, patients who are prone to suffer from eczema should exercise caution while planning to use Cleargel for acne or other bacterial skin infections.
Substitutes for Clear Gel:
Clindac A, Erytop Gel, Zyclin 1% gel, Acnesol 1% gel, D Acne 1% Gel, Mimosee 1% gel, Clenz 1% gel, Clinup 1% gel, Cleocin T, Clindagel, Clindaderm, Clindets, Evoclin.