Clindamycin Dosing for Dental Infections
For dental infections, clindamycin should be dosed at 300-450 mg orally every 6 hours for adults and 8-16 mg/kg/day divided into three or four equal doses for children. 1, 2
Adult Dosing
- 300-450 mg orally every 6 hours (4 times daily) 1, 2
- For more severe infections, use the higher end of the dosing range (450 mg every 6 hours) 1
- Duration of therapy is typically 7 days, depending on clinical response 2, 3
- Take with a full glass of water to avoid esophageal irritation 1
Pediatric Dosing
- For children who can swallow capsules: 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
- Alternative pediatric dosing: 10-13 mg/kg/dose every 6-8 hours, not to exceed 40 mg/kg/day 3, 4
- Clindamycin should be dosed based on total body weight regardless of obesity 1
Severe Dental Infections
- For severe infections with systemic symptoms, consider initial parenteral therapy with 600-900 mg IV every 8 hours 3, 4
- Transition to oral therapy when clinically appropriate 3
- Surgical drainage remains the primary treatment for dental abscesses, with antibiotics serving as adjunctive therapy 3, 5
Clinical Considerations
- Clindamycin is an appropriate alternative for patients with penicillin allergy 2
- In cases of β-hemolytic streptococcal infections, treatment should continue for at least 10 days 1
- Clindamycin has excellent activity against most oral pathogens, including anaerobes 6
- Monitor for clinical response - if significant improvement is seen after 2-3 days, some evidence suggests antibiotics could be discontinued, provided adequate drainage has been established 5
- If significant diarrhea occurs during therapy, discontinue clindamycin immediately due to risk of C. difficile-associated diarrhea 1
Efficacy
- Clindamycin has demonstrated comparable efficacy to other antibiotics like ampicillin in the treatment of odontogenic infections 7
- A randomized study showed comparable clinical success rates between clindamycin and amoxicillin/clavulanic acid for odontogenic infections 8
- Clindamycin has high oral absorption and significant tissue penetration, including penetration into bone 6