Clindamycin IV Dosage for Adults with Serious Infections
For adults with serious infections, the recommended IV clindamycin dosage is 600-900 mg every 8 hours (1800-2700 mg/day), with more severe infections requiring dosages up to 2700 mg/day in 2-4 divided doses. 1
Standard Dosing Recommendations
For Moderate to Severe Infections:
- Standard dosing: 600-900 mg IV every 8 hours (1800-2700 mg/day) 1, 2
- Duration: Based on type of infection and clinical response
For More Severe Infections:
- Higher dosing: 1200-2700 mg/day in 2,3, or 4 equal doses 1
- Life-threatening situations: Doses may be increased up to 4800 mg daily 1
Infection-Specific Dosing
MRSA Infections:
- Skin and soft tissue infections: 600 mg IV every 8 hours 2
- Pneumonia: 600 mg IV every 8 hours 2
- Osteomyelitis: 600 mg IV every 8 hours 2
- Septic arthritis: 600 mg IV every 8 hours 2
Non-MRSA Serious Infections:
- Necrotizing fasciitis: 600-900 mg IV every 6-8 hours 2
- Intra-abdominal infections: 900 mg IV every 8 hours has shown significantly higher cure rates (90.5%) compared to 600 mg every 8 hours (75.6%) 3
Administration Guidelines
IV Administration:
- Dilution: Concentration should not exceed 18 mg/mL 1
- Infusion rates: Should not exceed 30 mg/minute 1
- Standard infusion times:
- 300 mg: 50 mL over 10 minutes
- 600 mg: 50 mL over 20 minutes
- 900 mg: 50-100 mL over 30 minutes
- 1200 mg: 100 mL over 40 minutes
Alternative Continuous Infusion:
For maintaining specific serum levels:
- Above 4 mcg/mL: 10 mg/min for 30 min, then 0.75 mg/min
- Above 5 mcg/mL: 15 mg/min for 30 min, then 1.00 mg/min
- Above 6 mcg/mL: 20 mg/min for 30 min, then 1.25 mg/min 1
Important Considerations and Cautions
- Monitoring: Watch for diarrhea, which may indicate C. difficile infection; discontinue if this occurs 1
- Duration: For streptococcal infections, continue for at least 10 days 1
- Transition to oral therapy: Consider when clinically appropriate (300-450 mg oral dose four times daily) 2
- Single IM injections: Should not exceed 600 mg 1
Special Situations
- Babesiosis: For severe cases, 300-600 mg IV every 6 hours in combination with quinine 2
- Anaerobic lung infections: 600 mg IV every 6 hours has shown superior efficacy compared to penicillin 4
Remember that while 600 mg every 8 hours may be sufficient for some infections, the 900 mg every 8 hours dosage has demonstrated significantly better cure rates for intra-abdominal infections 3. For life-threatening infections, higher doses may be necessary, with up to 4800 mg daily having been used in adults 1.