From the Guidelines
For soft tissue infections, clindamycin is typically prescribed at a dose of 600 mg every 8 hours for adults, as recommended by the most recent guidelines 1.
Key Considerations
- The dosage may vary depending on the severity of the infection and the patient's clinical response.
- For children, the recommended dosage is 10-13 mg/kg/dose every 8 hours, as indicated in the guidelines 1.
- Treatment duration generally ranges from 7-14 days, depending on the severity of the infection and clinical response.
- Clindamycin is effective against many gram-positive organisms, including Staphylococcus aureus (including some MRSA strains) and Streptococcus species, making it suitable for skin and soft tissue infections.
- Patients should take the full course of antibiotics even if symptoms improve before completion.
- Common side effects include diarrhea, nausea, and abdominal pain, and patients should be advised to contact their healthcare provider if they develop severe or persistent diarrhea during or after treatment, due to the risk of Clostridioides difficile-associated diarrhea.
Important Notes
- The guidelines recommend clindamycin as an option for empirical coverage of CA-MRSA in outpatients with SSTI 1.
- Clindamycin should be used with caution in patients with a history of allergy to the medication or in those with certain medical conditions, such as liver or kidney disease.
- The guidelines emphasize the importance of individualizing treatment based on the patient's clinical response and adjusting the dosage and duration of treatment as needed.
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 dose and frequency of clindamycin for soft tissue infection are:
- Adults: 150 to 300 mg every 6 hours for serious infections and 300 to 450 mg every 6 hours for more severe infections.
- Pediatric Patients: 8 to 16 mg/kg/day divided into three or four equal doses for serious infections and 16 to 20 mg/kg/day divided into three or four equal doses for more severe infections 2.
From the Research
Dose and Frequency of Clindamycin for Soft Tissue Infection
- The ideal dose and frequency of clindamycin for soft tissue infections are not explicitly stated in the provided studies 3, 4, 5, 6, 7.
- However, clindamycin is often used in combination with other antibiotics, such as vancomycin, to treat necrotizing soft tissue infections (NSTIs) 4, 5.
- The duration of antibiotic treatment for NSTIs is generally between 7 and 15 days 3, but some studies suggest that a shorter course of antibiotic therapy (48 hours after source control) may be safe and effective 6.
- Clindamycin has been used to treat soft tissue infections, including those caused by Streptococcus and Staphylococcus species, and has been shown to be effective in reducing toxin production 3, 7.
- The choice of antibiotic regimen, including the use of clindamycin, should be based on the specific characteristics of the patient and the infection, as well as the results of culture and susceptibility testing 4, 5.
Comparison of Clindamycin with Other Antibiotics
- Clindamycin has been compared to linezolid in the treatment of NSTIs, with some studies suggesting that linezolid may be a safe and effective alternative to vancomycin and clindamycin 4, 5.
- However, other studies have found no significant difference in outcomes between patients treated with clindamycin and those treated with linezolid 5.