This page shows what was measured, who it was measured in, and what that does not settle.
What Clindamycin Phosphate does in the body
Protein production stalls and the bacteria stop multiplying.
Bacteria build their proteins on a machine called a ribosome, which is different enough from the human version that a drug can block one and leave the other alone. Clindamycin wedges itself into the part of the bacterial ribosome where each new amino acid gets stitched onto the growing chain. Enough of the drug crosses the skin into the bloodstream that the same effect reaches the bacteria in the gut, which is why a cream for the face carries a warning about the bowel.
Why people take it. Acne, when applied to the skin; serious bacterial infection when taken by mouth or by drip
What happened in people
Clindamycin-resistant Cutibacterium acnes counts rose more than 1,600% over 16 weeks of monotherapy and fell when benzoyl peroxide was added (P=0.018)
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
That a topical antibiotic outperforms benzoyl peroxide in inflammatory acne — every pooled comparison crosses no difference
Where it acts
The sebaceous follicle, where Cutibacterium acnes lives — and, unavoidably, the colon, because topical clindamycin is absorbed through the skin
Kind of result
The kind of result is not recorded
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
What the registries record it as
Its recorded molecular formula is C18H34ClN2O8PS, weighing 504.95.
US prescribing information · 0423007f-28fa-4159-bf58-9174626d2347 · read 2026-08-30
Where each sentence above came from
A person wrote this explanation into the record, with the studies named in the path below.
The recorded use, written for a reader without medical training. Not signed off.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 132 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Comparator
A comparator is whatever the treatment was measured against.
A picture of it, and where the picture fails
It is like the other runner in a race.
Where that stops being true. A race has one winner. A study can show both arms improved.
What people get wrong. Results are read without asking what the other group got. Beating nothing is not beating a treatment.
The control condition against which the experimental intervention is assessed.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Absolute difference
An absolute difference is how many more people in a hundred were affected.
A picture of it, and where the picture fails
It is like counting heads in two rooms of a hundred.
Where that stops being true. Heads are easy to count. Study results carry a margin of error too.
What people get wrong. It is confused with a percentage change, which can look far larger.
The arithmetic difference in event rates between arms.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Cutibacterium acnes and clindamycin-resistant C. acnes counts and lesion counts at 16 weeks, clindamycin/benzoyl peroxide against matching clindamycin alone
Total C. acnes P=0.002 and clindamycin-resistant count P=0.018 favouring combination; resistant counts rose more than 1,600% on clindamycin monotherapy. Lesion reductions P<=0.046
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The headline result is usually reported as the combination being more effective. The more consequential finding is what happened in the monotherapy arm, and it is a microbiological endpoint that no pivotal acne trial collects.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Treatment success at week 12 and absolute change in inflammatory and non-inflammatory lesion counts
✓ The study showed what it set out to show
Who was studied
IDP-126 phase 2, triple combination against three dyads (NCT03170388)
How many people
741
Study design
Phase 2, multicentre, randomised, double-blind, vehicle- and active-controlled
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Treatment success 52.5% against 8.1% vehicle and 27.8% to 30.5% across the three dyads, P<=0.001 for all; lesion reductions greater than every comparator, P<0.05
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. No limitation is recorded for this study.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
49.6% treatment success against 24.9% on vehicle, P<0.01; least-squares mean lesion reductions 72.7% to 80.1% against 47.6% to 59.6%, P<0.001
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Vehicle-controlled only. The dyad comparison that justified a three-drug product was not included, and the authors list inter-observer variation in severity ratings as a limitation.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
50.5% treatment success against 20.5% on vehicle, P<0.01
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Same design limitation as the companion trial: no active comparator arm of any kind.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Investigator’s global assessment at 12 weeks, benzoyl peroxide against clindamycin
✗ The study did not show it
Who was studied
Cochrane overview pooled clindamycin against benzoyl peroxide (CD014918)
How many people
2277
Study design
Overview of systematic reviews, pooled randomised evidence
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
RR 1.10 (95% CI 0.83 to 1.45), 2 trials, very low-certainty evidence; every other pooled outcome in the comparison also crosses no difference
Repeated elsewhere
Replicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. The overview records that no included review collected data for topical antibiotics against placebo or against topical retinoids, so clindamycin has no pooled placebo comparison at all.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
RNAWiki holds 5 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Clindamycin Phosphate
What a person takes: Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection.
The measurement behind this step
The topical forms deliver clindamycin phosphate, an inactive ester that skin phosphatases hydrolyse to free clindamycin. The label states that the topical formulation is absorbed from the skin surface, which is why systemic warnings apply. Modern products almost always pair it with benzoyl peroxide, or with benzoyl peroxide and adapalene in a single fixed-dose gel, because monotherapy selects resistance on the treated skin.
Getting in
Applied as an inactive ester that the skin switches on
What is in the bottle is not the working drug. It is a phosphate version with no antibacterial activity, which enzymes in the skin snip off to release the active molecule.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Clindamycin phosphate is a prodrug with no intrinsic antibacterial activity. Phosphatases in skin and plasma hydrolyse the 2-phosphate ester to free clindamycin. The ester exists for aqueous solubility and formulation stability, not for targeting, and its hydrolysis in the tube is a stability specification.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Not all of the drug stays where it is put. Enough passes through the skin to reach the rest of the body, and that is the entire reason a face lotion carries a warning about the bowel.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The topical label states directly that use of the topical formulation results in absorption of the antibiotic from the skin surface, and this is the stated basis for extending the systemic colitis warning to topical products. The absorbed fraction is small but not nil, and it reaches the colonic flora.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Inside the bacterium the drug jams itself into the exact spot where each new building block gets attached to a growing protein. The chain cannot be extended.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Clindamycin binds domain V of 23S rRNA in the 50S ribosomal subunit at the peptidyl transferase centre, overlapping the A-site and P-site substrate positions and blocking peptide bond formation and early chain elongation. It does not inhibit the human 80S ribosome, which is the basis for its selectivity.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Growth stops, and the survivors are the resistant ones
The bacteria stop multiplying rather than dying outright. Any organism that already carries a change in the target site keeps growing, and over weeks it inherits the space the others vacated.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Clindamycin is bacteriostatic against Cutibacterium acnes. Resistance arises from mutation at A2058 or G2057 in 23S rRNA or from erm-mediated methylation of A2058, which also confers macrolide cross-resistance because the binding pockets overlap. Sixteen weeks of monotherapy raised resistant colony counts by more than 1,600% in the controlled comparison.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Fewer bacteria and less inflammation mean fewer red spots. In the pooled comparisons this is the same amount of improvement an over-the-counter oxidising cream delivers.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Against benzoyl peroxide, pooled total lesion difference was MD -3.50 (95% CI -7.54 to 0.54) and investigator global assessment RR 1.10 (95% CI 0.83 to 1.45) across 2,277 participants, both crossing no difference. Clindamycin also has direct anti-inflammatory activity independent of bacterial killing, which is the proposed reason lesion counts fall faster than colony counts.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
The trials count spots on a face. Nothing in that count shows what has happened to the bacteria living on the rest of the patient, and the one trial that did look found the answer was unflattering.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Lesion counts and Evaluator’s Global Severity Score are the registration endpoints. Resistant-subpopulation counting is not part of any pivotal acne trial programme and was measured in a separate 79-patient microbiology study, where the resistant fraction rose more than 1,600% on monotherapy over 16 weeks.
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
People with inflammatory acne, almost always in a fixed combination rather than alone. Guidelines and labels have converged on never using it as monotherapy, and the trial evidence for why is on this page.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of XACIATO have not been established in pediatric patients younger than 12 years of age for the treatment of bacterial vaginosis.”
US prescribing information · 0423007f-28fa-4159-bf58-9174626d2347 · read 2026-08-30
On older people, the label states: “Clinical studies with XACIATO did not include any subjects 65 years of age or older to determine whether they respond differently than younger subjects.”
US prescribing information · 0423007f-28fa-4159-bf58-9174626d2347 · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary Other clindamycin vaginal products have been used to treat pregnant women during the second and third trimester.”
US prescribing information · 0423007f-28fa-4159-bf58-9174626d2347 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary Systemic absorption following intravaginal administration of clindamycin is low; therefore, transfer of clindamycin into breastmilk is likely to be low and adverse effects on the breastfed infant are not expected [see Clinical Pharmacology ( 12.3 )] .”
US prescribing information · 0423007f-28fa-4159-bf58-9174626d2347 · read 2026-08-30
Where the result stopped carrying
Monotherapy failed on its own microbiology, multiplying resistant organisms on patients’ faces more than sixteenfold in 16 weeks
The topical label qualifies its own Indications section with a direction to consider whether other agents are more appropriate
No pooled comparison of topical antibiotics against placebo exists in the 2024 Cochrane overview
Neither phase 3 trial of the triple combination retained the dyad comparison that made the product interesting
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (11)
It was studied for a different goal
The studies measured something else entirely. Nothing in this record points to this reason.
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Given by a clinician
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Suppression classes recorded: S6.
No source is stored against this line.
What is in the pack
The topical forms deliver clindamycin phosphate, an inactive ester that skin phosphatases hydrolyse to free clindamycin. The label states that the topical formulation is absorbed from the skin surface, which is why systemic warnings apply. Modern products almost always pair it with benzoyl peroxide, or with benzoyl peroxide and adapalene in a single fixed-dose gel, because monotherapy selects resistance on the treated skin.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
The topical label carries the colitis warning written for the systemic drug: diarrhoea, bloody diarrhoea and colitis including pseudomembranous colitis have been reported with topical as well as systemic use, and orally or parenterally administered clindamycin has been associated with severe colitis which may result in patient death. The drug should be discontinued when significant diarrhoea occurs, and antiperistaltic agents may prolong or worsen the condition. Local effects are dryness, erythema, burning and peeling, at rates not distinguishable from benzoyl peroxide in the pooled comparisons (RR 1.27, 95% CI 0.98 to 1.64).
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Where this came from
Cunliffe WJ, Holland KT, Bojar R, Levy SF. A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching c… · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Topical lotion, gel, foam and solution for acne; oral capsules and intravenous solution for systemic infection
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
The label states that the topical formulation is absorbed from the skin surface, which is why systemic warnings apply. Modern products almost always pair it with benzoyl peroxide, or with benzoyl peroxide and adapalene in a single fixed-dose gel, because monotherapy selects resistance on the treated skin.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
264 products list this as an active ingredient in the United States drug directory. 233 of them contain it and nothing else.
FDA National Drug Code directory · 71335-2863 · read 2026-08-29
They are sold as aerosol, foam, capsule, capsule, gelatin coated, cream, gel and injection, solution, taken intramuscular, intravenous, oral and topical.
FDA National Drug Code directory · 71335-2863 · read 2026-08-29
The regulator's established pharmacologic class for it is decreased sebaceous gland activity [pe], lincosamide antibacterial [epc] and lincosamides [cs].
FDA National Drug Code directory · 71335-2863 · read 2026-08-29
200 published labels name it as an active ingredient. 171 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · 5b8a6767-2d46-401c-9f85-d427dda9eff7 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · 5b8a6767-2d46-401c-9f85-d427dda9eff7 · read 2026-08-29
Clindamycin Phosphate is topical lotion at 1% (clindamycin phosphate equivalent to 10 mg clindamycin per milliliter), recorded as prescription product (rx only); fda label in effect 2024-03-22 in the United States.
US prescribing information · 00fe3546-a166-412f-a543-0ae7763c0ca0 · read 2026-08-27
Recorded price in US: 0.10483–0.25084 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 25 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 0.1302–3.48097 USD per one millilitre, across 11 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Recorded price in US: 1.83441–2.29615 USD per one gram, across 8 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.
Questions worth asking
Which of the trials of Clindamycin Phosphate studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That a topical antibiotic outperforms benzoyl peroxide in inflammatory acne — every pooled comparison crosses no difference
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the three-drug gel is established as better than the two-drug gels, when only the phase 2 trial made that comparison
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That topical clindamycin is a local treatment — the label states it is absorbed from the skin surface and extends the systemic colitis warning to it
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That resistance has made the drug ineffective, when population prevalence is around 3% and the demonstrated problem is within-patient selection
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Clindamycin Phosphate are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Sixteen weeks alone multiplied the resistant bacteria more than sixteenfold
In plain words
Seventy-nine patients were randomised to clindamycin gel or the identical gel with benzoyl peroxide added. By sixteen weeks the antibiotic-alone group had more than sixteen times as many clindamycin-resistant bacteria on their faces as when they started. The combination group had fewer.
What was measured
Clindamycin-resistant Cutibacterium acnes colony counts at 16 weeks, monotherapy against combination
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Cunliffe and colleagues enrolled 79 patients aged 13 to 30 with facial Cutibacterium acnes counts of at least 10^4 colony-forming units per square centimetre and randomised them to clindamycin 1% with benzoyl peroxide 5% or to matching clindamycin 1% alone, twice daily for 16 weeks; 70 were analysed. Clindamycin-resistant C. acnes counts rose by more than 1,600% at week 16 on monotherapy and fell from baseline on the combination (P=0.018 between groups). Total C. acnes count also fell significantly more on the combination (P=0.002). Reduction in resistant organisms correlated with reduction in inflammatory lesions (r2=0.31, P=0.016) and total lesions (r2=0.28, P=0.027), and the combination reduced total, inflammatory and comedonal lesion counts significantly more (P<=0.046). This is a single-centre trial in 70 analysed patients, and it is the study the whole no-monotherapy convention rests on.
Written into the record, not signed off as a reviewed claim
The label’s Indications section tells the prescriber to consider something else
In plain words
Most drug labels use the Indications section to say what the drug is for. This one says what it is for and then, in the same paragraph, tells the doctor to think about whether another treatment would be better, because of the risk of bloody diarrhoea and colitis from a lotion applied to a face.
What was measured
Regulatory label text — an indication qualified in its own first paragraph by a direction to consider alternatives
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
The topical clindamycin phosphate lotion label reads: "Clindamycin phosphate topical lotion is indicated in the treatment of acne vulgaris. In view of the potential for diarrhea, bloody diarrhea and pseudomembranous colitis, the physician should consider whether other agents are more appropriate." The Warnings section opens by stating that orally and parenterally administered clindamycin has been associated with severe colitis which may result in patient death, then that use of the topical formulation results in absorption of the antibiotic from the skin surface, and that diarrhoea, bloody diarrhoea and colitis including pseudomembranous colitis have been reported with topical as well as systemic clindamycin. It directs that the drug be discontinued when significant diarrhoea occurs and warns that antiperistaltic agents may prolong or worsen the condition.
Source
Clindamycin Phosphate Topical Lotion United States prescribing information, Indications and Usage and Warnings sections (ANDA 214604, openFDA label endpoint)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
No measurable advantage over benzoyl peroxide on any pooled outcome
In plain words
Pooled across trials with more than two thousand patients, an antibiotic that carries a colitis warning performed the same as an over-the-counter oxidising cream that carries none.
What was measured
That an antibiotic is the stronger option for inflammatory acne — every pooled comparison against benzoyl peroxide crosses no difference, and no pooled comparison against placebo exists at all
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The 2024 Cochrane overview reports that against clindamycin, benzoyl peroxide may have little to no effect on total lesion counts (MD -3.50, 95% CI -7.54 to 0.54; 1 trial, 641 participants), inflammatory lesion counts (MD -1.20, 95% CI -2.99 to 0.59), non-inflammatory lesion counts (MD -2.4, 95% CI -5.3 to 0.5), participant’s global self-assessment (RR 0.95, 95% CI 0.68 to 1.34; 1 trial, 240 participants), investigator’s global assessment (RR 1.10, 95% CI 0.83 to 1.45; 2 trials, 2,277 participants) or incidence of a less serious adverse event (RR 1.27, 95% CI 0.98 to 1.64; 5 trials, 2,842 participants). Certainty was very low or low for every estimate. The overview separately notes that no included review collected data comparing topical antibiotics with placebo at all.
Written into the record, not signed off as a reviewed claim
The triple combination beat all three of its own two-drug components
In plain words
A gel with an antibiotic, an oxidiser and a retinoid in it was tested against each of the three possible pairs and against a dummy gel, in seven hundred and forty-one people. It beat every one of them.
What was measured
Treatment success at week 12, triple combination against three dyads and vehicle in one randomised trial
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
A phase 2, double-blind, multicentre randomised 12-week study enrolled 741 participants aged 9 and over with moderate to severe acne, randomised equally to clindamycin phosphate 1.2%/benzoyl peroxide 3.1%/adapalene 0.15% gel, vehicle, or one of three component dyads. At week 12 treatment success — a two-grade reduction in Evaluator’s Global Severity Score plus clear or almost clear skin — was 52.5% on the triple against 8.1% on vehicle and 27.8% to 30.5% across the dyads, P<=0.001 for all. Absolute reductions in inflammatory (29.9) and non-inflammatory (35.5) lesions exceeded vehicle and all dyads (P<0.05, all), corresponding to more than 70% reduction. Registered as NCT03170388.
Written into the record, not signed off as a reviewed claim
The confirmatory trials dropped the comparison that mattered
In plain words
The finding that made the three-drug gel interesting was that it beat the two-drug versions. Neither of the two confirmatory trials that supported approval included a two-drug arm. Both compared it only with a gel containing nothing.
What was measured
That the three-drug gel is established as better than the two-drug gels — a single phase 2 trial made that comparison and neither confirmatory phase 3 trial repeated it
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The two phase 3, double-blind 12-week studies randomised 183 and 180 participants aged 9 and over 2:1 to once-daily triple-combination gel or vehicle gel. Treatment success at week 12 was 49.6% and 50.5% against 24.9% and 20.5% on vehicle (P<0.01 both), with least-squares mean lesion reductions of 72.7% to 80.1% against 47.6% to 59.6% (P<0.001 all). Neither trial contained a dyad arm, so the superiority over two-drug combinations rests on the single phase 2 study. The authors list inter-observer bias and variation in acne severity ratings, limited treatment duration and population generalisability as limitations. Registered as NCT04214639 and NCT04214652; approved under NDA 216632.
Written into the record, not signed off as a reviewed claim
Clindamycin resistance is real but far rarer than the reputation suggests
In plain words
The story people tell is that acne antibiotics have stopped working because of resistance. Pooling thirty-nine studies, about three in a hundred acne bacteria were clindamycin-resistant. For erythromycin, the drug clindamycin largely replaced, it was thirty-seven in a hundred.
What was measured
That topical clindamycin has been rendered ineffective by resistance — the pooled prevalence is around 3%, and the case against monotherapy rests on within-patient selection rather than on population-level failure
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
A random-effects meta-analysis of 39 studies estimated the pooled proportion of clindamycin-resistant Cutibacterium acnes isolates at 0.031 (95% CI 0.014 to 0.071). Erythromycin resistance was 0.366 (95% CI 0.302 to 0.434) and azithromycin 0.149 (95% CI 0.061 to 0.322); doxycycline 0.079, tetracycline 0.062 and minocycline 0.025. The authors’ own conclusion still describes a concerning increase in resistant C. acnes with antibiotic use in acne. Both readings are supportable and they are not in conflict: the population-level prevalence is low, and the within-patient selection effect demonstrated in the 16-week monotherapy trial is large. What a pooled prevalence cannot capture is what happens to one person’s own skin flora over a course of treatment.
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What is not here
7 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What was measured, goal by goal — found nothing in the sources checked.
How close this is to real life — found nothing in the sources checked.
Felt, measured, or meaningful — found nothing in the sources checked.
How long anything takes — found nothing in the sources checked.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A lincosamide that jams the bacterial ribosome at the peptidyl transferase centre — indistinguishable from benzoyl peroxide on every pooled acne outcome, and shown in a controlled 16-week trial to raise clindamycin-resistant Cutibacterium acnes counts on the patient’s own face by more than 1,600% when used alone, which is why the modern product is a three-drug gel and why the topical label tells prescribers to consider whether another agent would be more appropriate.
Recorded evidence blocks (10)
Q2
On the Clindamycin Phosphate label: indicated for what?
"Clindamycin phosphate vaginal cream 2%, is indicated in the treatment of bacterial vaginosis (formerly referred to as Haemophilus vaginitis, Gardnerella vaginitis, nonspecific vaginitis, Corynebacterium vaginitis, or anaerobic vaginosis). Clindamycin phosphate vaginal cream 2%, can be used to treat non-pregnant women…": indications and usage on Clindamycin Phosphate's label. DailyMed label · b52bdaf7-3b54-4165-9ab0-9dfa08170e47 · 2026-08-06
Q3
104 registered trials of Clindamycin Phosphate — at which phases?
Registered studies posting no result
75 of 104
104 registered studies of Clindamycin Phosphate: 34 phase4, 21 na, 21 phase3, 13 phase2, 7 phase1, 6 na or unstated, 4 early phase1. CLINICALTRIALS_SNAPSHOT · 2026-09-01
982 with a PubMed record
Show the evidence
phase4
34
na
21
phase3
21
phase2
13
phase1
7
na or unstated
6
9 more recorded rows
early phase1
4
completed
61
unknown
12
recruiting
11
terminated
7
withdrawn
7
active not recruiting
3
not yet recruiting
2
enrolling by invitation
1
recorded 2026-09-01 · last checked 2026-09-04
Q4
12 of Clindamycin Phosphate's trials stopped: futility/efficacy, accrual/recruitment, funding/business, other?
futility/efficacy (1), accrual/recruitment (6), funding/business (3) and other (2): Clindamycin Phosphate's stop wording, clustered. CLINICALTRIALS_SNAPSHOT · 2026-09-01
"The study was closed due to poor enrollment and lack of interest."; 12 of 104 registered studies
Show the evidence
Trial
NCT01498744
terminated; "The study was closed due to poor enrollment and lack of interest."
NCT01619410
terminated; "slow accrual"
NCT01715610
withdrawn; "unsuccessful recruitment"
NCT01899690
withdrawn; "The study was withdrawn prior to IRB approval."
NCT02099240
terminated; "Not enough patient enrollment and lack of staffing"
NCT02168816
terminated; "The study was stopped for feasibility (i.e., low recruitment)"
6 further recorded trials
NCT02730962
terminated; "Delays in IND approval caused a lack of funding to conduct the trial."
NCT03173053
terminated; "Results interim-analysis"
NCT03357419
withdrawn; "difficulties in production placebo antibiotics"
NCT03779295
withdrawn; "No subjects enrolled."
NCT04834310
withdrawn; "Do not have adequate funding to proceed with project."
NCT06207786
withdrawn; "Lack of resources to support the trial"
recorded 2026-09-01 · last checked 2026-09-04
Q5
Human studies of Clindamycin Phosphate used Clindamycin 300 mg capsule — over how long?
studies of Clindamycin Phosphate used the recorded amount. ClinicalTrials.gov · 2026-09-01
16 recorded entries; human; capsule, intravenous, oral; also "Clindamycin 300 mg capsule", "Cleocin HCl 300 mg capsules", "clindamycin phosphate 1.2% and tretinoin 0.025%"
Show the evidence
human
NCT00836004
capsule; Clindamycin 300 mg capsule
NCT00836004
Cleocin HCl 300 mg capsules
NCT01047189
clindamycin phosphate 1.2% and tretinoin 0.025%
NCT01047189
clindamycin 1% gel
NCT01874860
Clindamycin 1 % gel
NCT02005666
Clindamycin Phosphate 1.2% / Benzoyl Peroxide 5% Gel
10 more recorded rows
humanNCT02005666
1.2% Clindamycin Phosphate/ 5% Benzoyl Peroxide Gel of CHL
humanNCT02674191
(150g Clindamycin/tds) for 1 week
humanNCT03257202
Clindamycin 1% Gel
humanNCT03374176
Clindamycin 300 mg
humanNCT04194216
intravenous; Intra-operative single intravenous(iv) dose of "cephalexin" 2 g or "clindamycin" 900 mg.
humanNCT04194216
oral; Intra-operative single dose (iv) of "cephalexin" 2 g or "clindamycin" 900 mg and postoperative oral dose of "cephalexin" 250mg (every 4 hours) or "clindamycin" 150mg(every 6 hours) for 3 days
humanNCT05867654
oral; oral clindamycin 300mg q6hrs
humanNCT06068673
Clindamycin 600 mg
humanNCT06068673
Dalacin 600 mg
humanNCT07392047
Clindamycin Topical Gel 1%
recorded 2026-09-01 · last checked 2026-09-04
Q6
Clindamycin Phosphate's half-life is 1.5 to 2.6 hours — which schedules were studied?
1.5 to 2.6 hours; The systemic half-life was 1.5 to 2.6 hours.
tmaxpharmacokinetics
10 hours; These peak concentrations were attained approximately 10 hours post-dosing (range 4–24 hours).
recorded 2026-08-06 · last checked 2026-09-04
Q7
Which running trial of Clindamycin Phosphate could settle lifespan?
NCT05137119 measures All-cause mortality at 90 days after platform entry, reading out 2028-12-01.
1 open trial; n 8000; "Staphylococcus Aureus Network Adaptive Platform Trial"
Show the evidence
TrialNCT05137119
"Staphylococcus Aureus Network Adaptive Platform Trial"; n 8000; "All-cause mortality at 90 days after platform entry"; 2028-12-01
Q8
Which 30 trials of Clindamycin Phosphate posted no result?
Posted no result
30 of 30 completed trials
Registrations
NCT00000717, NCT00000674, NCT00000640, NCT00219570, NCT00361322 and NCT00214643, and 24 more
Completion dates
oldest 1991-11; newest 2024-06-10
Show the evidence
Trial
NCT00000717
1991-11
NCT00000674
1992-08
NCT00000640
1994-09
NCT00219570
2005-06
NCT00361322
2006-01
NCT00214643
2006-07
14 further recorded trials
NCT00503542
2008-02
NCT01125410
2009-02
NCT00757523
2009-06-24
NCT00616330
2009-12
NCT00642980
2011-06
NCT01244698
2014-05
NCT01876628
2016-03
NCT01800825
2016-04
NCT02446782
2016-06
NCT02018094
2017-01-02
NCT01874860
2018-07
NCT05106803
2019-10-01
NCT04134273
2019-10-15
NCT04321070
2020-03-06
Q9
At the median, Clindamycin Phosphate's trials enrolled 100 people — anything larger?
Median enrolment
100
Largest enrolment
8000
Registered trials counted
103
Q10
What do 3548 spontaneous reports say about Clindamycin Phosphate — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Clindamycin Phosphate appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 3548 reaction mentions were counted: drug hypersensitivity 1769; rash 461; rash maculo-papular 226; urticaria 213. FAERS via Open Targets · CHEMBL3184512 · 2026-06-24
Show the evidence
drug hypersensitivity
1769
rash
461
rash maculo-papular
226
urticaria
213
acute kidney injury
201
acute generalised exanthematous pustulosis
199
4 more recorded rows
drug reaction with eosinophilia and systemic symptoms
145
clostridium difficile infection
129
dermatitis allergic
104
clostridium difficile colitis
101
recorded 2026-06-24 · last checked 2026-09-04
Q11
Which 10 reactions does Clindamycin Phosphate's label not list?
acute generalised exanthematous pustulosis, acute kidney injury and clostridium difficile colitis and 7 more reported for Clindamycin Phosphate, absent from its label. FAERS via Open Targets · CHEMBL3184512 · 2026-06-24
3 label terms; 10 reported and unlisted; b52bdaf7-3b54-4165-9ab0-9dfa08170e47
Show the evidence
acute generalised exanthematous pustulosis
count not stated
acute kidney injury
count not stated
clostridium difficile colitis
count not stated
clostridium difficile infection
count not stated
dermatitis allergic
count not stated
drug hypersensitivity
count not stated
4 more recorded rows
drug reaction with eosinophilia and systemic symptoms
count not stated
rash
count not stated
rash maculo-papular
count not stated
urticaria
count not stated
recorded 2026-06-24 · last checked 2026-09-04
Where it is registeredIdentifiers, relations and other names
ChEMBL 37 — CC BY-SA 3.0 Unported · ClinicalTrials.gov — US Government work · Open Targets 26.06 — CC0 · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
✗ required summary fields resolved: 4 required field(s) not terminal: Why people use it, Best-supported result, Biggest unanswered question, Human evidence
✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 6 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
This is a record of evidence. It is not medical advice, and it does not say this substance suits you. Nothing here says any substance on RNAWiki is appropriate for a child.