This sheet is about exposure to clindamycin in pregnancy and while breastfeeding. This information is based on available published research. It should not take the place of medical care and advice from your healthcare provider.

What is clindamycin?

Clindamycin is an antibiotic used to treat or prevent bacterial infections. It can be taken by mouth (oral), used on the skin (topical), or given by IV (intravenous or by needle into a vein).

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take this medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

I take clindamycin. Can it make it harder for me to get pregnant?

It is not known if clindamycin can make it harder to get pregnant.

Does taking clindamycin increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. One study involving 249 women who had a vaginal bacterial infection found that clindamycin treatment reduced the chances of late miscarriage.

Does taking clindamycin increase the chance of birth defects?

Every pregnancy starts out with about a 1 in 33 (3%) chance of having a birth defect. This is called the background chance. It is unlikely that using clindamycin increases the chance of birth defects. Several human studies as well as animal studies have not shown an increased chance of birth defects.

When clindamycin is used on the skin (topical use), only small amounts pass through skin and get into the bloodstream. This means a pregnancy would be exposed to only a very small amount of the medicine. Since available information about vaginal and oral clindamycin (both higher absorptions compared to topical use) does not find an increased chance of birth defects, it is also unlikely that using topical clindamycin increases the chance of birth defects.

Does taking clindamycin in pregnancy increase the chance of other pregnancy related problems?

Several studies have not found an increased chance of other pregnancy-related problems such as low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). One study involving 249 women who had a vaginal bacterial infection found that clindamycin treatment reduced the chances of preterm delivery (birth before week 37).

Does taking clindamycin in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if clindamycin can cause behavior or learning issues for the child.

Breastfeeding while taking clindamycin:

Clindamycin gets into breastmilk in small amounts when women are given clindamycin orally (by mouth) or intravenously (IV). In those situations, clindamycin might cause some gastrointestinal (GI) effects in a breastfeeding (e.g. nausea, diarrhea, stomach pain, vomiting, diaper rash, thrush, or rarely bloody stools). Topical application (to the skin) has minimal absorption into the body and are unlikely to end up in breast milk in amounts that might cause side effects in a nursing baby. If you notice any symptoms in your child, contact their healthcare provider. Be sure to talk to your healthcare provider about all of your breastfeeding questions.

If a male takes clindamycin, could it affect fertility or increase the chance of birth defects?

Studies have not been done to see if clindamycin could affect male fertility (ability to get partner pregnant) or increase the chance of birth defects above the background risk. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Selected References:

• Lamont RF, et al. 2003. The efficacy of vaginal clindamycin for the treatment of abnormal genital tract flora in pregnancy. Infect Dis Obstet Gynecol, 11(4):181-189. [PMC free article: PMC1852293] [PubMed: 15108863]
• Mackeen AD, et al. 2015. Antibiotic regimens for postpartum endometritis. Cochrane Database Syst Rev, 2015(2):CD001067. [PMC free article: PMC7050613] [PubMed: 25922861]
• Mann CF. 1980. Clindamycin and breast-feeding. Pediatrics, 66:1030-1031. [PubMed: 7454470]
• McCormack WM, et al. 1987. Effect on birth weight of erythromycin treatment of pregnant women. Obstet Gynecol, 69:202-207. [PubMed: 3543767]
• McGready R, et al. 2001. Randomized comparison of quinine-clindamycin versus artesunate in treatment of falciparum malaria in pregnancy. Trans R Soc Trop Med Hyg, 95:651-656. [PubMed: 11816439]
• Mitrano JA, et al. 2009. Excretion of antimicrobials used to treat methicillin-resistant Staphylococcus aureus infections during lactation: safety in breastfeeding infants. Pharmacotherapy, 29(9):1103-1109. [PubMed: 19698015]
• Muanda F, et al. 2017. Use of antibiotics during pregnancy and the risk of major congenital malformations: a population based cohort study. Br J Clin Pharmacol, 83:2557-2571. [PMC free article: PMC5651310] [PubMed: 28722171]
• Nahum GG, et al. 2006. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol, 107(5):1120-1138. [PubMed: 16648419]
• Onwuchuruba CN, et al. 2014. Transplacental passage of vancomycin from mother to neonate. Am J Obstet Gynecol, 210(4):352.e1-4. [PubMed: 24679944]
• Ou MC, et al. 2001. Antibiotic treatment for threatened abortion during the early first trimester in women with previous spontaneous abortion. Acta Obstet Gynecol Scand, 80(8):753-756. [PubMed: 11531620]
• Reboucas KF, et al. 2019. Treatment of bacterial vaginosis before 28 weeks of pregnancy to reduce the incidence of preterm labor. Int J Gynecol Obstet, 146(3):271-276. [PubMed: 31022300]
• Smith JA, et al. 1975. Clindamycin in human breast milk. Can Med Assoc J, 112:806 [PMC free article: PMC1958966] [PubMed: 20312646]
• Steen B, Rane A. 1982. Clindamycin passage into human milk. Br J Clin Pharmacol, 13:661-664. [PMC free article: PMC1402074] [PubMed: 7082533]
• Subtil D, et al. 2018. Early clindamycin for bacterial vaginosis in pregnancy (PREMEVA): a multicentre, double-blind, randomised controlled trial. Lancet, 392(10160):2171-2179. [PubMed: 30322724]
• Ugwumadu A, et al. 2003. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. Lancet, 361:983-988. [PubMed: 12660054]
• Weinstein AJ et al. 1976. Placental transfer of clindamycin and gentamicin in term pregnancy. Am J Obstet Gynecol, 124:688-691. [PubMed: 943947]