From the Guidelines
For pediatric skin infections, clindamycin is typically dosed at 10-13 mg/kg/dose every 8 hours, as recommended by the Infectious Diseases Society of America in 2014 1. This dosage is effective against many gram-positive organisms, including Staphylococcus aureus (including MRSA) and Streptococcus species, which commonly cause skin infections. Some key points to consider when prescribing clindamycin for pediatric skin infections include:
- The maximum daily dose should not exceed the recommended amount, and the treatment duration is usually 7-10 days, depending on the severity and response to therapy.
- Clindamycin can be administered orally as a liquid suspension or capsules for children who can swallow pills.
- It's essential to complete the full course of antibiotics even if symptoms improve before completion.
- Clindamycin works by inhibiting bacterial protein synthesis, and common side effects include diarrhea, nausea, and abdominal pain.
- Parents should be advised to contact their healthcare provider if the child develops severe diarrhea, as clindamycin can occasionally cause Clostridioides difficile infection. The recommended dosage of 10-13 mg/kg/dose every 8 hours is based on the most recent and highest-quality studies available, including those published in 2014 by the Infectious Diseases Society of America 1. In contrast to older studies, such as the one published in 2005 1, which recommended a dosage range of 10-20 mg/kg/day in 3 divided doses, the more recent guidelines provide a more specific and evidence-based recommendation for the use of clindamycin in pediatric skin infections. Overall, the use of clindamycin for pediatric skin infections should be guided by the most recent and highest-quality evidence available, with careful consideration of the potential benefits and risks of treatment.
From the FDA Drug Label
Pediatric Patients (for children who are able to swallow capsules): Serious infections – 8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses. More severe infections – 16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses. For pediatric patients with skin infections, the recommended dosage of clindamycin is:
- Serious infections: 8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses
- More severe infections: 16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses 2
From the Research
Clindamycin Dosage for Pediatric Skin Infections
There is limited information available on the specific dosage of clindamycin for pediatric skin infections in the provided studies.
- The studies primarily focus on the use of amoxicillin-clavulanate, ticarcillin plus clavulanate, and gentamicin plus clindamycin in various surgical and infection scenarios 3, 4, 5.
- None of the studies directly address the dosage of clindamycin for pediatric skin infections.
- However, one study mentions the use of parenteral clindamycin as standard prophylaxis in contaminated head and neck surgery, but does not provide information on pediatric dosages 4.
- Another study compares amoxicillin-clavulanate with gentamicin plus clindamycin as perioperative prophylaxis in clean-contaminated abdominal surgery, but again, does not provide information on pediatric dosages 5.
Available Information on Clindamycin
- Clindamycin is mentioned as a treatment option in the context of contaminated head and neck surgery, where it is used as a standard prophylaxis 4.
- The study also explores the use of topical clindamycin, but the focus is on its efficacy in reducing bacterial counts in the oral cavity, rather than its use in pediatric skin infections 4.
Limitations of Available Evidence
- The provided studies do not offer direct guidance on the dosage of clindamycin for pediatric skin infections.
- The evidence is primarily focused on the use of antibiotics in surgical settings, rather than the treatment of skin infections in pediatric patients.