What is the recommended dose of Clindamycin (Clindamycin) for treating skin and soft tissue infections?

Clindamycin Dosing for Skin and Soft Tissue Infections

For skin and soft tissue infections in adults, use clindamycin 300-450 mg orally every 6-8 hours for mild-to-moderate infections, or 600-900 mg intravenously every 6-8 hours for severe infections. 1

Adult Dosing by Severity

Mild-to-Moderate Infections (Oral Therapy)

• 300-450 mg orally every 6 hours (four times daily) is the standard oral regimen 1, 2
• The FDA label specifies 150-300 mg every 6 hours for serious infections, escalating to 300-450 mg every 6 hours for more severe infections 2
• Take with a full glass of water to avoid esophageal irritation 2

Severe Infections (Intravenous Therapy)

• 600-900 mg intravenously every 6-8 hours for severe non-purulent skin and soft tissue infections 1
• For MRSA infections specifically: 600 mg intravenously every 8 hours 1
• For MSSA infections: 600 mg intravenously every 8 hours 1

Pediatric Dosing

Oral Therapy

• 30-40 mg/kg/day divided into 3-4 doses (not to exceed adult dosing) 1
• FDA label specifies 8-16 mg/kg/day for serious infections and 16-20 mg/kg/day for more severe infections, divided into 3-4 equal doses 2
• Only for children who can swallow capsules whole; use clindamycin palmitate oral solution otherwise 2

Intravenous Therapy

• 25-40 mg/kg/day divided into 3 doses for MSSA infections 1
• 10-13 mg/kg/dose every 8 hours intravenously for severe non-purulent infections 1
• Dose based on total body weight regardless of obesity 2

Treatment Duration

• 7 days minimum for uncomplicated skin and soft tissue infections, extending treatment if infection has not improved within this timeframe 1
• At least 10 days for β-hemolytic streptococcal infections 2
• Duration depends on clinical response; some complicated infections may require 10-14 days or longer 3

Critical Considerations

MRSA Coverage

• Clindamycin is an important option for MRSA skin infections, particularly in children 1
• Caution: Potential for inducible resistance in erythromycin-resistant strains and cross-resistance with MRSA 1
• Consider testing for inducible clindamycin resistance (D-test) in MRSA isolates before use 1

Key Warnings

• Discontinue immediately if significant diarrhea occurs due to risk of Clostridioides difficile infection 2
• Clindamycin is bacteriostatic, not bactericidal 1
• For penicillin-allergic patients, clindamycin is an excellent alternative for both MSSA and MRSA infections 1