Class: Lincosamide Antibiotic
Dosage Forms. Capsule: 75 mg, 150 mg, 500 mg; Granules for Solution: 75 mg/5 mL
Common FDA Label Indication, Dosing, and Titration.
1. Bacterial infectious disease, susceptible infections due to anaerobic organisms, Staphylococci, Streptococci, Pneumococci: Adults, 150-450 mg po q6h; Children, 8-20 mg/kg/d po divided q6-8h
2. Infection of skin and/or subcutaneous tissue: Adults, 150-450 mg po q6h; Children, 8-20 mg/kg/d po divided q6-8h
3. Infectious disease of abdomen: Adults, 150-450 mg po q6h; Children, 8-20 mg/kg/d po divided q6-8h
4. Lower respiratory tract infection: Adults, 150-450 mg po q6h; Children, 8-20 mg/kg/d po divided q6-8h
5. Pelvic inflammatory disease: Adults, 150-450 mg po q6h; Children, 8-20 mg/kg/d po divided q6-8h
6. Septicemia: Adults, 150-450 mg po q6h; Children, 8-20 mg/kg/d po divided q6-8h
1. Bacterial vaginosis, oral treatment, pregnant women with symptomatic disease: 300 mg po bid × 7 d
2. Streptococcal pharyngitis, penicillin-allergic patients: Children, 20 mg/kg/d po in 3 divided doses (max 1.8 g/d)
MOA. Clindamycin is a semisynthetic 7-chloro-7-deoxylincomycin derivative that is active against most Gram-positive organisms except enterococci and Clostridium difficile. Gram-negative aerobes are resistant, but most anaerobes are sensitive. It inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit; it is bactericidal or bacteriostatic depending on the concentration, organism, and inoculums.
Drug Characteristics: Clindamycin
Medication Safety Issues: Clindamycin
Drug Interactions: Clindamycin
Adverse Reactions: Clindamycin
Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection.
Toxicity Monitoring Parameters. Seek medical attention if heart palpitations, blistering skin rash, or profuse watery diarrhea.
Key Patient Counseling Points. Complete full course of therapy. Symptoms should improve within 2-3 d; if they worsen, seek follow-up with healthcare practitioner. Take with full glass of water. Remain upright for 30 min after dose to minimize risk of GI ulceration.
Clinical Pearls. May resume normal activities after 24 h of antibiotics and if afebrile. Prolonged use may result in fungal or bacterial superinfection, including C difficile-associated diarrhea, which has been observed >2 m postantibiotic treatment.