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Because the kidney can serve a concentrating function, it is conceivable that clindamycin hydrochloride could be detected in urine but not in serum after topical application. Nonetheless, by our assay we were unable to detect clindamycin in serum.
We, too, are concerned about the reports of diarrhea associated with topical clindamycin therapy. Richard Stoughton, MD (verbal communication, November, 1977), informed us that there have been no cases of pseudomembranous colitis or ulcerated rectal mucosa associated with topical application of clindamycin. The patient to which Dr Voron refers had, according to Dr Stoughton, only rectal edema and petechiae.
Algra RJ, Rosen T, Waisman M. Systemic Absorption of Topical Clindamycin-Reply. Arch Dermatol. 1978;114(5):798. doi:10.1001/archderm.1978.01640170092028