Clindamycin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

IV-$18/d PO-$2/d

Dosing

150-450 mg PO q6-8h

600-900 mg IV q8h

20-30 mg/kg/24h PO divided q6-8h
Maximum: 1.8 g/24h

25-40 mg/kg/24h IV divided q6-8h
Maximum: 900 mg/dose

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 and 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

Monitor for:

  • Diarrhea -if severe diarrhea, consider C.diff infection

  • CBC

  • Hepatic Function

  • Renal function

Adverse Effects

  • Allergy (immediate & delayed)

  • GI upset, diarrhea, pseudomembranous colitis

  • Cytopenia

  • Abnormal liver enzymes

Oral Liquids

Concentration: 15 mg/mL
Taste: less palatable, unpleasant taste
Not all strengths of oral liquids are listed nor are available on IWK formulary

Tablet/Capsule Strengths

150 mg capsule
Tablets and capsules are preferred especially over an unpleasant tasting liquid.
Not all strengths of oral tablets/capsules are listed and they are not all available on the IWK formulary.

Additional Information

Some preparations of Clindamycin injection contain benzyl alcohol, which has caused gasping syndrome in neonates.

Pharmacology

Antimicrobial class: Lincosamide

Average serum half life:

  • Premature neonates: 8.7 hours

  • Full term neonates: 3.6 hours.

  • Infants 1 month to 1 year: 3 hours.

  • Children and Adults: 2-3 hours

Route of Elimination: Mostly hepatic metabolism. 10% of an oral dose excreted in urine and 3.6% excreted in feces as active drug and metabolites.