Clindamycin

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:
  • 1200-2700 mg/day IM divided q6-12h
  • First Dose: 600 mg IM x 1
  • Max: 600 mg/dose IM
• IV
  • 1200-2700 mg/day IV divided q6-12h
  • First Dose: 600-900 mg IV x 1
  • 4800 mg/day IV

Cellulitis Possibly due to MRSA (Unlabled Use)

• PO: 300-450mg q8hr x 5-10 days

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 Infection (Severe)

• <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
• >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
• Adolescents
  • 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

General Infection (Mild-Moderate)

• 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
• 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

Cellulitis Possibly due to MRSA (Unlabeled Use)

• PO: 10-13 mg/kg/dose q6-8hrs x 5-10 days
• First Dose: 2.5-4.3 mg/kg PO x 1
• Max: 40 mg/kg/day

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

See Also

• Antibiotics (Main)

Source

• Epocrates