What is the typical dosage of clindamycin (antibiotic) for adults and children?

Clindamycin Dosage Guidelines for Adults and Children

The recommended dosage of clindamycin for adults is 150-300 mg orally every 6 hours for serious infections and 300-450 mg every 6 hours for more severe infections, while pediatric dosing is 8-16 mg/kg/day divided into three or four equal doses for serious infections and 16-20 mg/kg/day for more severe infections. 1

Adult Dosing

Oral Administration

• For serious infections: 150-300 mg every 6 hours 1
• For more severe infections: 300-450 mg every 6 hours 1
• For skin and soft tissue infections: 300-450 mg four times daily 2

Intravenous Administration

• For skin and soft tissue infections: 600 mg every 8 hours 2
• For severe infections: 600-900 mg every 6-8 hours 2
• For pelvic inflammatory disease: 900 mg every 8 hours (typically with gentamicin) 2

Pediatric Dosing

Oral Administration

• For serious infections: 8-16 mg/kg/day divided into three or four equal doses 1
• For more severe infections: 16-20 mg/kg/day divided into three or four equal doses 1
• For MRSA infections: 30-40 mg/kg/day divided into 3-4 doses 3, 4
• For Group A Streptococcal infections: 40 mg/kg/day in 3 doses 4

Intravenous Administration

• For MRSA infections: 40 mg/kg/day divided every 6-8 hours 3, 2
• For pneumonia: 10-13 mg/kg/dose every 6-8 hours, not to exceed 40 mg/kg/day 3
• For Group A Streptococcal infections: 7-10 mg/kg every 6-8 hours (up to a maximum of 600 mg per dose) 3

Special Considerations

Duration of Therapy

• For β-hemolytic streptococcal infections: at least 10 days 1
• For skin and soft tissue infections: 7-14 days depending on clinical response 2
• Intravenous therapy should continue for at least 48 hours after clinical improvement before transitioning to oral therapy 2

Administration Guidelines

• Oral clindamycin should be taken with a full glass of water to avoid esophageal irritation 1
• For children who cannot swallow capsules, clindamycin palmitate oral solution should be used 1
• Clindamycin should be dosed based on total body weight regardless of obesity 1

Combination Therapy

• For babesiosis: Clindamycin (300-600 mg every 6-8 hours IV or 600 mg every 8 hours orally for adults; 7-10 mg/kg every 6-8 hours for children) plus quinine (650 mg every 6-8 hours orally for adults; 8 mg/kg every 8 hours for children) 3

Important Cautions

• If significant diarrhea occurs during therapy, clindamycin should be discontinued 1
• Higher doses (600 mg) are associated with increased frequency and severity of gastrointestinal side effects compared to lower doses (300 mg) 5
• Almost all patients (98%) may experience some side effects from oral clindamycin, with higher doses causing more prolonged symptoms 5

Pathogen-Specific Considerations

• For methicillin-resistant Staphylococcus aureus (MRSA) infections susceptible to clindamycin, oral dosing should be 30-40 mg/kg/day in 3-4 doses for children 3
• For methicillin-susceptible Staphylococcus aureus infections in children, oral clindamycin should be given at 30-40 mg/kg/day in 3-4 doses 2

This dosing information provides a comprehensive guide for clinicians prescribing clindamycin for various infections in both adult and pediatric populations, with specific considerations for route of administration, severity of infection, and pathogen susceptibility.