Clindamycin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

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

Dosing

General Pediatric

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

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

Adult

150-450 mg PO q6-8h

600-900 mg IV q8h

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

Additional Information

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

Pharmacology

Antimicrobial class: Lincosamide

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.

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