Clindamycin (Dalacin) Dosage and Usage for Bacterial Infections
The recommended dosage of Dalacin (clindamycin) for bacterial infections varies based on severity, with adults typically receiving 150-300 mg orally every 6 hours for serious infections and 300-450 mg every 6 hours for more severe infections, or 600-900 mg IV every 8 hours for parenteral therapy. 1, 2
Adult Dosing Recommendations
Oral Administration
- For serious infections: 150-300 mg every 6 hours 2
- For more severe infections: 300-450 mg every 6 hours 2
- For skin and soft tissue infections: 300-450 mg three times daily for 5-10 days 3
- Take with a full glass of water to avoid esophageal irritation 2
Intravenous Administration
- For serious infections due to aerobic gram-positive cocci and susceptible anaerobes: 600-1,200 mg per day in 2,3, or 4 equal doses 1
- For more severe infections, particularly those due to Bacteroides fragilis, Peptococcus species, or Clostridium species: 1,200-2,700 mg per day in 2,3, or 4 equal doses 1
- For life-threatening infections: Doses up to 4,800 mg daily have been given intravenously 1
- Single intramuscular injections of greater than 600 mg are not recommended 1
Indication-Specific Dosing
Skin and Soft Tissue Infections
- For uncomplicated skin infections: 300-450 mg orally three times daily for 5-10 days 3
- For complicated skin infections: 600 mg IV or orally three times daily for 7-14 days 3
- For necrotizing infections: 600-900 mg IV every 8 hours, often combined with other antibiotics 3
Bone and Joint Infections
- For osteomyelitis: 600 mg IV or orally every 8 hours, with a minimum treatment duration of 8 weeks 3
- For septic arthritis: Same dosing as osteomyelitis, with treatment duration of 3-4 weeks 3
Intra-abdominal Infections
- Recommended dose: 600-900 mg IV every 8 hours 3
- Often combined with agents active against gram-negative bacteria 4
Administration Guidelines
IV Administration
- The concentration of clindamycin in diluent for infusion should not exceed 18 mg/mL 1
- Infusion rates should not exceed 30 mg per minute 1
- Common dilution: 300-1200 mg in 50-100 mL of diluent, infused over 10-40 minutes 1
Compatibility Information
- Compatible with IV solutions containing sodium chloride, glucose, calcium, or potassium 1
- Physically incompatible with: ampicillin sodium, phenytoin sodium, barbiturates, aminophylline, calcium gluconate, and magnesium sulfate 1
Special Considerations
Duration of Treatment
- For β-hemolytic streptococcal infections: Treatment should continue for at least 10 days 1, 2
- For osteomyelitis: Minimum of 8 weeks 3
- For complicated skin infections: 7-14 days 3
Monitoring
- Assess clinical response within 48-72 hours of initiating therapy 3
- Monitor for diarrhea, which may indicate Clostridioides difficile-associated diarrhea (CDAD) 1, 2
Important Precautions
- If significant diarrhea occurs during therapy, discontinue the antibiotic immediately 1, 2
- Pseudomembranous colitis has been reported with nearly all antibacterial agents, including clindamycin, and may range in severity from mild to life-threatening 5
Pediatric Dosing (For Reference)
- For serious infections: 8-16 mg/kg/day divided into three or four equal doses 2
- For more severe infections: 16-20 mg/kg/day divided into three or four equal doses 2
- For parenteral administration: 20-40 mg/kg/day in 3 or 4 equal doses 1
Clindamycin is particularly effective against anaerobic bacteria, especially beta-lactamase-producing strains of Bacteroides species, and has good activity against aerobic gram-positive cocci such as Staphylococcus aureus (including MRSA) and streptococci 5, 6. However, it lacks activity against aerobic gram-negative rods like E. coli, which is why it's often combined with other antibiotics for mixed infections 6, 7.