Clindamycin is efficient against most odontogenic pathogens, and its use in odontogenic infection is justified, despite not being given for prophylaxis. Regarding adverse reactions, clostridium is associated with diarrhea, on which basis it is excluded from AHA and ESC guidelines; this adverse reaction is associated with all wide-spectrum antibiotics. Therefore, the warning applies to all antibiotics (including clindamycin), which have reported side effects (from mild diarrhea to more severe forms of colitis) associated with C. difficile (CDI). These warnings entered the drug information in the period from 2010 to 2014, when they were placed in the ‘Warnings’ section of the drug label. The warnings were subsequently placed in the black box, due to the increasing number of reports of such side effects associated with the use of antibiotics, including clindamycin, in the United States of America. Also, there is a certain group of patients more prone to exhibit this reaction. These are patients older than 65, patients with a previous history of hospitalization, patients frequently receiving antibiotic therapy, and patients on parenteral nutrition. Regarding IE, current guidelines by the AHA and the ESC take into account a narrow spectrum of clinical conditions with a high risk of IE occurrence in which antibiotic prophylaxis should be prescribed before invasive dental procedures., Antibiotic prophylaxis in dentistry usually involves a single dose of antibiotics 30 min to 1 h before an invasive dental procedure, and its effectiveness is short-lived, limited to several hours after the procedure during transient bacteremia., The American Dental Association and American Heart Association no longer recommend the antibiotic clindamycin for dental prophylaxis or therapeutic use. It has a black box warning for C. difficile diarrhea because the risk is high and there have been dental lawsuits..