Maximum Daily Dose of Clindamycin
For adults, the maximum recommended dose of clindamycin is 2,700 mg per day (900 mg every 8 hours) for severe infections, while for pediatric patients the maximum is 40 mg/kg/day. 1
Adult Maximum Dosing
The highest recommended adult dose is 900 mg intravenously every 8 hours (2,700 mg/day total) for severe infections. 1 This dosing is specifically recommended by the Infectious Diseases Society of America for serious infections and by the CDC for pelvic inflammatory disease. 1
For oral administration, the FDA-approved maximum is 450 mg every 6 hours (1,800 mg/day total) for more severe infections. 2 However, this represents the upper limit for oral dosing specifically.
Route-Specific Adult Maximums:
- Intravenous: 900 mg every 8 hours = 2,700 mg/day maximum 1
- Oral: 450 mg every 6 hours = 1,800 mg/day maximum 2
The 900 mg every 8 hours regimen has demonstrated superior cure rates compared to 600 mg every 8 hours in intraabdominal infections (90.5% vs 75.6%, p=0.03), supporting its use as the maximum effective dose for severe infections. 3
Pediatric Maximum Dosing
For children, the maximum dose is 40 mg/kg/day, typically divided into 3-4 doses or administered every 6-8 hours. 1, 4 This maximum applies across multiple infection types including MRSA, pneumonia, and Group A Streptococcal infections. 1
Pediatric Dosing by Route:
- Intravenous: 10-13 mg/kg/dose every 6-8 hours (not to exceed 40 mg/kg/day total) 1
- Oral: 30-40 mg/kg/day divided into 3-4 doses 1
The FDA label for oral clindamycin specifies that more severe pediatric infections can be treated with 16-20 mg/kg/day, but guideline recommendations consistently cap the maximum at 40 mg/kg/day regardless of severity. 1, 2
Critical Dosing Considerations
Clindamycin should be dosed based on total body weight regardless of obesity. 2 This is an important FDA-specified consideration that prevents underdosing in obese patients.
Common Pitfall to Avoid:
Do not exceed 600 mg per single dose in pediatric patients, even when calculating 40 mg/kg/day for larger children, as this represents the practical upper limit per dose. 1