Clindamycin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

IV: $$$
PO: $

Dosing

Adult

300-450mg IV q8h for usual indications

900mg IV q8h for necrotizing skin/soft tissue infections or toxic shock syndrome

300-450mg PO q6h

Renal

CrCl >50 mL/min

  • 600 - 900 mg IV Q8h

  • 300 - 450 mg PO Q8h

CrCl <50 mL/min

  • No change

Hepatic

Consider dose reduction in hepatic insufficiency

General Information

Common Usage

Anaerobic infections above the diaphragm, especially dental infection.

Gram positive skin and soft tissue infections including necrotizing fasciitis as an adjunctive agent to a beta-lactam for reducing toxin production.

Skin & soft tissue infections involving susceptible MRSA.

Susceptible infections and surgical prophylaxis in setting of IgE mediated beta-lactam allergy.

For decreasing toxin production in toxic shock syndrome.

Drug Monitoring

Laboratory

  • Not routinely indicated

Clinical

  • Hypersensitivity

  • GI effects

  • Photosensitivity

Adverse Effects

  • Diarrhea

  • C. difficile

Major Interactions

  • ¬†Muscle relaxants, e.g., atracurium, baclofen, diazepam.

  • ¬†St. Johns Wort

Pharmacology

Antimicrobial class: Lincosamide

Pregnancy category: B

Average serum half life: 2.4 hours

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor