JC is a 19-year-old college student who presents to the ED with a new-onset “boil” on his right buttock. He noticed some pain and irritation in the right buttock area over the past week but thought it was due to having slid into second base during a baseball game. The pain gradually increased over the next few days, and he went to the student health center, where they cleaned the wound and gave him a prescription for clindamycin 300 mg QID for 7 days. They recommended he try to keep the area covered until the antibiotic began to work. Today (7 days later), JC returned to the student health center for further evaluation and was referred to the ED for further care for his continued SSTI. At the ED, JC says the area on his buttock is worse, and he cannot sit down for class. He reports only partial adherence to the clindamycin regimen, because he often forgets to take it and says it makes him nauseated. JC is not on any other medications. Allergies: Penicillin (hives as a child; told to him by mother). In checking JC’s vaccination history you noticed he only has received his COVID-19 Vaccine Primary Series – 2 dose Moderna Series 6 months ago. When asked about Moderna vaccine he said he has a sore arm and was lethargic after his second dose.
Do you think that clindamycin was an appropriate initial antibiotic choice for JC, what advantages or disadvantages does it have over other options? Of the available alternative antibiotic agents which agent would you prescribe JC? What information should be provided to the patient to enhance compliance, ensure successful therapy, and minimize adverse effects? What recommendations would you make to JC in regards to COVID-19 vaccination?