Clindamycin Dosing Frequency
Clindamycin should be administered every 6-8 hours for most bacterial infections, with the specific frequency depending on infection severity and route of administration. 1, 2
Adult Dosing Frequency
Intravenous Administration
- Every 8 hours (three times daily) is the standard frequency for most serious infections, with doses of 600-900 mg per administration 1, 2
- For severe or life-threatening infections (necrotizing fasciitis, streptococcal toxic shock), use 600-900 mg every 6-8 hours 1, 2
- For pelvic inflammatory disease, administer 900 mg every 8 hours in combination with gentamicin 2
Oral Administration
- Every 6 hours (four times daily) is the FDA-approved frequency for serious infections at 150-300 mg per dose 3
- For more severe infections, give 300-450 mg every 6 hours 3
- Alternative dosing of 300-450 mg three times daily may be used for uncomplicated purulent cellulitis 2
Pediatric Dosing Frequency
Intravenous Administration
- Every 6-8 hours at 10-13 mg/kg/dose (maximum 40 mg/kg/day total) for MRSA and serious infections 1, 2
- For Group A Streptococcus infections, administer 40 mg/kg/day divided every 6-8 hours 2
Oral Administration
- Three to four times daily with total daily dose of 30-40 mg/kg/day for MRSA infections 2
- For serious infections, use 8-16 mg/kg/day divided into three or four equal doses 3
- For more severe infections, increase to 16-20 mg/kg/day divided into three or four equal doses 3
Infection-Specific Frequency Considerations
Necrotizing Infections
- Administer 600-900 mg every 8 hours IV for streptococcal infections (combined with penicillin) 1
- For mixed infections, use 600-900 mg every 8 hours IV as part of combination therapy 1
Skin and Soft Tissue Infections
- IV: 600 mg every 8 hours for complicated infections 2
- Oral: 300-450 mg four times daily (every 6 hours) for outpatient management 2, 3
Critical Dosing Principles
The every 6-8 hour frequency is essential for maintaining therapeutic drug levels, as clindamycin has a relatively short half-life requiring frequent dosing to sustain bacteriostatic concentrations 1, 2
Common Pitfalls to Avoid
- Do not underdose by extending intervals beyond 8 hours for serious infections, as this leads to subtherapeutic levels and treatment failure 2
- Do not use once or twice daily dosing - clindamycin pharmacokinetics do not support extended-interval dosing 1, 3
- For β-hemolytic streptococcal infections, continue treatment for at least 10 days regardless of clinical improvement 3
Administration Considerations
- Take oral capsules with a full glass of water to avoid esophageal irritation 3
- Transition from IV to oral therapy after at least 48 hours of clinical improvement 2
- Total treatment duration (IV plus oral) should be 7-14 days depending on infection severity and clinical response 2