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Clindamycin

Medical and Pharmacy Editor:

Brand Name(s): Cleocin, Cleocin Pediatric, Clindesse, ClindaMax Vaginal

Generic Name: clindamycin

Drug Class: Antibiotics, Lincosamide

What Is Clindamycin and How Does It Work?

Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria.

Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of colitis, before selecting clindamycin, the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin).

Clindamycin is available under the following different brand names: Cleocin, Cleocin Pediatric, Clindesse, and ClindaMax Vaginal.

Dosages of Clindamycin

Adult and Pediatric Dosage Forms & Strengths

Capsule

  • 75 mg
  • 150 mg
  • 300 mg

Injectable solution

  • 150mg/mL

Oral solution

  • 75 mg/5mL

Intravenous solution

  • 300 mg/50mL (5% dextrose)
  • 600 mg/50mL (5% dextrose)
  • 900 mg/50mL (5% dextrose)

Dosage Considerations – Should be Given as Follows:

Serious Infections Caused by Anaerobic Bacteria

Adult: 150-450 mg orally every 6-8 hours; not to exceed 1.8 g/day, OR

1.2-2.7 g/day intravenously (IV)/intramuscularly (IM) divided every 6-12 hours; not to exceed 4.8 g/day

Pediatric:

Younger than 7 days:

  • Less than 2 kg (or older than 7 days, less than 1.2 kg): 10 mg/kg/day IV/IM divided every 12 hours
  • Greater than 2 kg (or older than 7 days, 1.2-2 kg): 15 mg/kg/day IV/IM divided every 8 hours

Older than 7 days:

  • Greater than 2 kg: 20 mg/kg/day IV/IM divided every 6 hours

Younger than 1 month:

  • 15-20 mg/kg/day divided every 6-8 hours

Older than 1 month:

  • Hydrochloride: 8-20 mg/kg/day orally
  • Palmitate: 8-25 mg/kg/day divided every 6-8 hours; 37.5 mg every 6 hours minimum palmitate dose

Amnionitis

450-900 mg IV every 8 hours

Inhalational & Gastrointestinal Anthrax (Off-label)

Adult: 900 mg IV every 8 hours with ciprofloxacin 400 mg orally every 12 hours or doxycycline 150-300 mg orally every 12 hours

Pediatric: 15-40 mg/kg/day IV divided every 6-8 hours

Pediatric: 8-25 mg/kg/day orally divided every 6-8 hours

Bacterial Vaginosis

300 mg orally every 12 hours for 7 days

Surgical Prophylaxis

900 mg oral/IV 1 hour prior to procedure; may re-dose every 6 hours if necessary

Bite Wounds (Human or Animal)

300 mg orally every 6 hours

Gangrenous Pyomyositis

900 mg IV every 8 hours with penicillin G

Group B Streptococcus

Neonatal prophylaxis

900 mg IV every 8 hours until delivery

Streptococcal Pharyngitis, Pediatric

May consider use in patients allergic to penicillin (IDSA guidelines)

Chronic carrier treatment: 20-30 mg/kg/day orally divided every 8 hours; not to exceed 300 mg/dose

Acute treatment in penicillin-allergic patients: 7 mg/kg/dose three times a day for 10 days; not to exceed 300 mg/dose

Orofacial/Parapharyngeal Space Infections

Adult:

150-450 mg orally every 6 hours for at least 7 days; not to exceed 1.8 g/day, OR

600-900 mg IV every 8 hours

Pediatric:

10-20 mg/kg/day orally divided every 6-8 hours, OR

15-25 mg/kg/day IV divided every 6-8 hours

May adjust dose as necessary not to exceed 40 mg/kg/day

Pelvic Inflammatory Disease

900 mg IV every 8 hours with gentamicin 2 mg/kg; THEN 1.5 mg/kg every 8 hours; continue after discharge with doxycycline 100 mg orally every 12 hours to complete 14 days of therapy

Toxic Shock Syndrome

900 mg IV every 8 hours plus oxacillin or nafcillin (2 g IV every 4 hours) or vancomycin (30 mg/kg/day IV divided every 12 hours)

Endocarditis Prophylaxis (Off-label)

Adult: 600 mg oral/IV/IM 30-60 min before procedure

Avoid IM injections in patients receiving anticoagulant therapy; administer orally in these circumstances; in general, administer IV only if patient does not tolerate or is unable to absorb oral medications

Dosing considerations

  • Recent AHA guidelines recommend only for high-risk patients undergoing invasive procedures

Pediatric Prophylaxis

20 mg/kg orally 30-60 min before procedure, OR

600 mg IV or orally every 6 hours for at least 6 weeks

CNS Toxoplasmosis, With Pyrimethamine or Leucovorin (Off-label)

600 mg IV or orally every 6 hours for at least 6 weeks

Gardnerella Vaginalis (Off-label)

PO: 300 mg orally every 12 hours for 7 days

Pneumocystis (carinii) jiroveci (Off-label)

30 mg/kg/day divided every 6-8 hours

300-450 mg orally every 6-8 hours with primaquine for 21 days

600-900 mg IV every 6-8 hours with primaquine for 21 days

Pediatric Dosing Modifications

IM: No more than 600 mg per injection

Administration

Oral: May take with food

Medically Reviewed by a Doctor on 4/14/2017




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