From the Guidelines
Clindamycin is typically dosed at 300-450 mg orally every 6-8 hours for adults with most infections, with a maximum daily dose of 1800 mg, as recommended by the most recent guidelines 1. For severe infections, 600-900 mg can be given intravenously every 8 hours.
- The oral dose for children is 10–13 mg/kg/dose PO every 6–8 h, not to exceed 40 mg/kg/day, as stated in the guidelines 1.
- The IV dose for children is 10–13 mg/kg/dose PO/IV every 6–8 h, not to exceed 40 mg/kg/day. Treatment duration generally ranges from 7-14 days depending on the infection type and severity.
- Clindamycin should be taken with a full glass of water, and can be taken with food if stomach upset occurs. This antibiotic works by inhibiting bacterial protein synthesis by binding to the 50S ribosomal subunit, making it effective against many gram-positive aerobic bacteria and anaerobes.
- It achieves good penetration into bone and abscesses, making it valuable for treating dental infections, bone and joint infections, and skin/soft tissue infections, as noted in the guidelines 1. Patients should be monitored for diarrhea, which could indicate Clostridioides difficile infection, a serious potential side effect.
- The most recent guidelines recommend clindamycin 600 mg 6-hourly for the treatment of anorectal emergencies 1.
From the FDA Drug Label
Adults: Serious infections – 150 to 300 mg every 6 hours. More severe infections – 300 to 450 mg every 6 hours Pediatric Patients (for children who are able to swallow capsules): Serious infections – 8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses. More severe infections – 16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses.
The recommended dosing of Clindamycin is as follows:
- Adults:
- Serious infections: 150 to 300 mg every 6 hours
- More severe infections: 300 to 450 mg every 6 hours
- Pediatric Patients:
- Serious infections: 8 to 16 mg/kg/day divided into three or four equal doses
- More severe infections: 16 to 20 mg/kg/day divided into three or four equal doses 2
From the Research
Clindamycin Dosing
- The provided studies do not directly address clindamycin dosing, but rather compare the effectiveness of different antibiotics, including clindamycin, in treating various infections 3, 4, 5, 6, 7.
- Study 4 mentions that clindamycin was used as a treatment for severe invasive group A streptococcus skin and soft tissue infections, but does not specify the dosing.
- Study 5 also mentions the use of clindamycin as an adjunctive therapy for invasive group A streptococcal infections, but does not provide dosing information.
- Study 6 compares the safety of clindamycin plus vancomycin versus linezolid for the treatment of necrotizing soft tissue infections, but does not specify the dosing of clindamycin.
- Study 7 compares the effects and safety of linezolid and vancomycin for treating skin and soft tissue infections, but does not provide information on clindamycin dosing.
Antibiotic Comparisons
- The studies compare the effectiveness of different antibiotics, including clindamycin, linezolid, and vancomycin, in treating various infections 3, 4, 5, 6, 7.
- Study 3 compares linezolid to vancomycin in the treatment of complicated skin and soft tissue infections, and finds that linezolid is superior to vancomycin in treating infections due to methicillin-resistant Staphylococcus aureus (MRSA) 3.
- Study 4 compares linezolid to clindamycin in the treatment of severe invasive group A streptococcus skin and soft tissue infections, and finds no difference in treatment outcomes between the two antibiotics 4.
- Study 5 compares adjunctive linezolid to clindamycin in the treatment of invasive group A streptococcal infections, and finds that linezolid is non-inferior to clindamycin 5.
- Study 6 compares clindamycin plus vancomycin to linezolid in the treatment of necrotizing soft tissue infections, and finds no difference in 30-day mortality between the two treatment groups 6.
- Study 7 compares linezolid to vancomycin in the treatment of skin and soft tissue infections, and finds that linezolid is more effective than vancomycin in treating infections due to MRSA 7.