Clindamycin: Difference between revisions
Line 42: | Line 42: | ||
===General Severe Infection (Neonates)=== | ===General Severe Infection (Neonates)=== | ||
*'''<1 week old''' | *'''<1 week old''' | ||
** | **''<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'' | ||
***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'' | ||
***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'' | ||
***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'' | ||
***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
- <2kg
- 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
- <1.2kg
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
- C. difficile associated diarrhea
- Thrombocytopenia
- Anaphylaxis
- Stevens-Johnson Syndrome
- Granulocytopenia
- Esophagitis
Common
- Diarrhea
- Nausea and Vomiting
- Abdominal Pain
- Rash
- Puritis
- Jaundice
- Urticaria
- Hypotension
- Thrombophlebitis (IV use)
Pharmacology
- Half-life: 2.4-3h
- Metabolism: Liver; CYP450
- Excretion: Urine, feces
- Mechanism of Action: Bacteriostatic or bactericidal, depending on bug/concentration