II. Indications
- Activity spectrum
- Gram Positive Bacteria
- Anaerobic Bacteria infection
- No activity against Gram Negative Bacteria
- Conditions (FDA approved)
- Intraabdominal infections (must be combined with Gram Negative coverage, e.g. Aminoglycosides)
- Peritonitis
- Pelvic Inflammatory Disease
- Skin and Soft Tissue Infections
- MRSA Pneumonia
- MRSA Osteomyelitis
- SBE Prophylaxis
- Intraabdominal infections (must be combined with Gram Negative coverage, e.g. Aminoglycosides)
- Conditions (off-label)
- See Clindamycin Topical
- Orofacial infections
- Bacterial Vaginosis
- Necrotizing Fasciitis or Toxic Shock Syndrome (as part of multi-drug regimen)
- Streptococcal Pharyngitis (in Penicillin allergic patients)
- Malaria
- Anthrax
- Babesiosis
III. Mechanism
- Lincosamide Antibiotic
- Derivative of lincomycin, originally isolated from soil actinomycete Streptomyces lincolnensis
- Anti-Ribosomal Antibiotic
IV. Dosing: General
- See Clindamycin Topical
- Take capsules with water to prevent esophageal irritation
- May take with or without food
- Reduce dose in hepatic dysfunction
V. Dosing: Adult
- Oral
- Moderate infections: 300 to 450 mg orally three to four times daily
- Severe or complicated infections: 600 mg orally three times daily
- IV: 600 to 900 mg IV every 8 hours
- IM: up to 600 mg every 8 hours
VI. Dosing: Child
-
Preterm Infant
- IV: 15 mg/kg/day IV divided three times daily
- Term Infants < 1 month
- IV: 15 to 20 mg/kg/day IV divided three times daily
- Child
- IV: 20 to 40 mg/kg/day IV divided every 6 to 8 hours
- PO: 8 to 20 mg/kg/day orally divided three to four times daily
VII. Pharmacokinetics
- Both renal and hepatic excretion
- Actively transported into abscesses
- Does not enter cerebrospinal fluid
VIII. Adverse Effects
- Abdominal cramping
- Diarrhea
-
Pseudomembranous colitis (Clostridioides difficile)
- Although most systemic Antibiotics risk C. diff, Clindamycin has been most associated historically
IX. Safety
- Considered safe in pregnancy
- Considered safe in Lactation
X. Drug Interactions
-
CYP3A4 Inducers
- Decrease Clindamycin serum levels
XI. Resources
- Clindamycin Phosphate Injection (DailyMed)
- Clindamycin Hydrochloride Capsule (DailyMed)
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Related Studies
| clindamycin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CLINDAMYCIN (PEDI) 75 MG/5 ML | Generic | $0.19 per ml |
| CLINDAMYCIN 2% VAGINAL CREAM | Generic | $1.62 per gram |
| CLINDAMYCIN HCL 150 MG CAPSULE | Generic | $0.11 each |
| CLINDAMYCIN HCL 300 MG CAPSULE | Generic | $0.26 each |
| CLINDAMYCIN HCL 75 MG CAPSULE | Generic | $0.33 each |
| CLINDAMYCIN PH 1% GEL | Generic | $0.46 per gram |
| CLINDAMYCIN PH 1% SOLUTION | Generic | $0.28 per ml |
| CLINDAMYCIN PHOS 1% PLEDGET | Generic | $0.31 each |
| CLINDAMYCIN PHOSP 1% LOTION | Generic | $0.50 per ml |
| CLINDAMYCIN PHOSPHATE 1% FOAM | Generic | $4.51 per gram |
| CLINDAMYCIN PHOSPHATE 1% GEL | Generic | $9.41 per ml |
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| cleocin (on 3/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CLEOCIN 100 MG VAGINAL OVULE | $58.57 each | |
| CLEOCIN T 1% LOTION | Generic | $0.50 per ml |