What is the dosing regimen for a 300 mg clindamycin (antibiotic) capsule in an adult patient with normal renal function?

Clindamycin 300 mg Capsule Dosing

For adults with normal renal function, clindamycin 300 mg capsules are dosed at 300-450 mg every 6 hours for serious to severe infections. 1

Standard Adult Dosing Regimens

The FDA-approved dosing for clindamycin capsules varies by infection severity: 1

• Serious infections: 150-300 mg every 6 hours 1
• More severe infections: 300-450 mg every 6 hours 1

The 300 mg capsule strength is typically administered every 6 hours (four times daily) for most serious bacterial infections. 1

Administration Guidelines

• Take with a full glass of water to avoid esophageal irritation 1
• Capsules must be swallowed whole; patients unable to do so require the oral solution formulation 1
• Dosing should be based on total body weight regardless of obesity 1

Specific Clinical Scenarios

For targeted MRSA infections, higher doses are often recommended: 2

• MRSA osteomyelitis: 600 mg every 8 hours (IV or oral) for minimum 8 weeks 2
• Babesiosis (with quinine): 300-600 mg every 6 hours IV or 600 mg every 8 hours orally for 7-10 days 2
• Dental prophylaxis (penicillin allergy, renal failure on dialysis): 600 mg single dose 1 hour before procedure 2

Renal Impairment Considerations

No dosage adjustment is necessary in renal failure, including patients on hemodialysis. 3, 4, 5 This is a critical advantage of clindamycin over many other antibiotics. 6

• Clindamycin is not significantly removed by hemodialysis 3, 5
• Normal adult doses (150-300 mg four times daily) can be given safely in chronic renal failure 3
• For severe renal impairment with severe infections, avoid exceeding 300 mg every 5 hours intramuscularly 4

Duration of Therapy

• β-hemolytic streptococcal infections: Continue for at least 10 days 1
• Discontinue immediately if significant diarrhea occurs due to risk of Clostridioides difficile infection 1

Common Pitfalls

• Do not use capsules in children unable to swallow them whole; switch to oral solution for accurate mg/kg dosing 1
• Monitor elderly patients closely as they often have unrecognized decreased renal function (GFR decreases ~8 mL/min per decade after age 40), though dose adjustment is typically not required 6
• Watch for pseudomembranous colitis, which can occur during or after treatment and requires immediate discontinuation 1