Clindamycin: Difference between revisions

Line 42: Line 42:
===General Severe Infection (Neonates)===
===General Severe Infection (Neonates)===
*'''<1 week old'''
*'''<1 week old'''
**'''<2kg'''
**''<2kg''
***10 mg/kg/day IM/IV divided q12
***10 mg/kg/day IM/IV divided q12
***First Dose: 5 mg/kg IM/IV x 1
***First Dose: 5 mg/kg IM/IV x 1
**'''>2kg'''
**''>2kg''
***15 mg/kg/day IM/IV divided q8h
***15 mg/kg/day IM/IV divided q8h
***First Dose: 5 mg/kg IM/IV x 1
***First Dose: 5 mg/kg IM/IV x 1
*'''1 week - 1 month'''
*'''1 week - 1 month'''
**'''<1.2kg'''
**''<1.2kg''
***10 mg/kg/day IM/IV divided q12h
***10 mg/kg/day IM/IV divided q12h
***First Dose: 5 mg/kg IM/IV x 1
***First Dose: 5 mg/kg IM/IV x 1
**'''1.2-2kg'''
**''1.2-2kg''
***15 mg/kg/day IM/IV divided q8h
***15 mg/kg/day IM/IV divided q8h
***First Dose: 5 mg/kg IM/IV x 1
***First Dose: 5 mg/kg IM/IV x 1
**'''>2kg'''
**''>2kg''
***20 mg/kg/day IM/IV divided q6-8h
***20 mg/kg/day IM/IV divided q6-8h
***Alt: 30 mg/kg/day IM/IV divided q6h
***Alt: 30 mg/kg/day IM/IV divided q6h

Revision as of 02:38, 10 March 2014

General

  • Type: Other antibiotics
  • Dosage Forms: IM, IV, PO (75mg; 150mg; 300mg; 75mg/5mL)
  • Common Trade Names: Cleocin

Adult Dosing

General

  • PO:
    • 150-450mg PO q6h
    • First Dose: 150-450mg PO x 1
    • Max: 450 mg/dose PO (increased risk of C. diff at higher doses)
  • IM:
    • 600-2700 mg/day IM divided q6-12h
    • First Dose: 600 mg IM x 1
    • Max: 600 mg/dose IM
  • IV
    • 600-2700 mg/day IV divided q6-12h
    • First Dose: 600-900 mg IV x 1
    • 4800 mg/day IV

Strep. Pharyngitis

  • 300mg PO q8 x 10 days

Bacterial Vaginosis

  • 300mg PO q12h x 7 days

PID

  • PO (Mild-mod)
    • 450mg PO q6h x 14 days
    • Use with ceftriaxone or cefoxitin/probenecid if no proceeding IV treatment
  • IV (Severe)
    • 900mg IV q8
    • Use with gentamicin and switch to PO after 24h of clinical improvement

Babesiosis

  • 600 mg PO q8h x 7-10 days
  • Alt: 300-600mg IV q6h x 7-10 days
    • First Dose: 300-600mg IV x 1
  • Give with quinine; use IV for severe infections

Pediatric Dosing

General Severe Infection (Neonates)

  • <1 week old
    • <2kg
      • 10 mg/kg/day IM/IV divided q12
      • First Dose: 5 mg/kg IM/IV x 1
    • >2kg
      • 15 mg/kg/day IM/IV divided q8h
      • First Dose: 5 mg/kg IM/IV x 1
  • 1 week - 1 month
    • <1.2kg
      • 10 mg/kg/day IM/IV divided q12h
      • First Dose: 5 mg/kg IM/IV x 1
    • 1.2-2kg
      • 15 mg/kg/day IM/IV divided q8h
      • First Dose: 5 mg/kg IM/IV x 1
    • >2kg
      • 20 mg/kg/day IM/IV divided q6-8h
      • Alt: 30 mg/kg/day IM/IV divided q6h
      • First Dose: 5-7.5 mg/kg IM/IV x 1

General Severe Infection (>1 Month - Children)

  • 25-40 mg/kg/day IM/IV divided q6-8h
  • First Dose: 6.25-13.3 mg/kg IM/IV x 1
  • Max: 4.8 g/day IM/IV
  • Max: 1.8 g/day PO

General Severe Infection (Adolescents)

  • 25-40 mg/kg/day IM/IV divided q6-8h
  • First Dose:
  • Max: 4.8 g/day IM/IV
  • Max: 1.8 g/day PO
  • Alt: 300-450mg PO q6h

General Mild-Mod Infection (Infants & Children)

  • PO:
    • 10-25 mg/kg/day PO divided q6-8h
    • First Dose: 2.5-8.3 mg/kg PO x 1
    • Max: 1.8 g/day PO
  • IM/IV:
    • 15-25 mg/kg/day IM/IV divided q6-8
    • First Dose: 3.75-8.3 mg/kg IM/IV x 1
    • 4.8 g/day IM/IV

General Mild-Mod Infection (Adolescents)

  • PO:
    • 150-300mg PO q6h
    • First Dose: 150-300mg PO x 1
    • Max: 1.8 g/day PO
  • IM/IV:
    • 25-40 mg/kg/day IM/IV divided q6-8h
    • First Dose: 6.25-13.3 mg/kg IM/IV x 1
    • Max: 4.8 g/day IM/IV

Otitis Media, Acute

  • 2mo-5yo
    • 30-40 mg/kg/day PO divided q8h x 10 days
  • 6-12yo
    • 30-40 mg/kg/day PO divided q8h x 5-10 days

Sinusitis

  • 30-40 mg/kg/day PO divided q8h x 10-14 days
  • Use with cefixime or cefpodoxime

Streptococcal Pharyngitis

  • 7 mg/kg PO q8h x 10 days
  • Max: 300mg/dose

Community-Acquired Pneumonia (>3mo)

  • IV (Mod-Severe): 40 mg/kg/day IV divided q6-8h x 10-14 days
  • PO (Mild): 30-40 mg/kg/day PO divided q6-8h x 7-10 days

Babesiosis

  • 20-40 mg/kg/day PO/IV divided q6-8h x 7-10 days
  • Max: 600 mg/dose
  • Info: Use with quinine

Special Populations

  • Pregnancy: B
  • Lactation: Possibly unsafe
  • Renal Dosing (Adult & Pediatric)
    • No adjustment
    • No supplement for hemodialysis or peritoneal dialysis
    • Pediatric
  • Hepatic Dosing (Adult & Pediatric)
    • No adjustment

Contraindications

Black Box

  • High risk for C. difficile associated diarrhea
    • Reserve for serious infections where there is not alternative

General

  • Allergy to class/drug
  • Ulcerative colitis

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 2.4-3h
  • Metabolism: Liver; CYP450
  • Excretion: Urine, feces
  • Mechanism of Action: Bacteriostatic or bactericidal, depending on bug/concentration

See Also

Source