From the Guidelines
Clindamycin is recommended for the treatment of streptococcal pharyngitis in individuals with penicillin allergy, with a dosage of 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days.
Treatment Details
- The dosage of clindamycin for streptococcal pharyngitis is 7 mg/kg/dose 3 times daily, with a maximum dose of 300 mg/dose 1.
- The recommended duration of treatment with clindamycin is 10 days 1.
- Clindamycin is a suitable alternative for individuals with penicillin allergy, with a resistance rate of approximately 1% among GAS isolates in the United States 1.
Key Considerations
- The treatment of streptococcal pharyngitis is crucial to prevent complications such as acute rheumatic fever and suppurative complications 1.
- Accurate diagnosis of streptococcal pharyngitis is essential to prevent unnecessary antibiotic use and reduce the risk of antibiotic resistance 1.
- Clindamycin is one of the recommended antibiotics for the treatment of streptococcal pharyngitis in individuals with penicillin allergy, along with other options such as cephalexin, cefadroxil, azithromycin, and clarithromycin 1.
From the FDA Drug Label
Adults: Serious infections – 150 to 300 mg every 6 hours. More severe infections – 300 to 450 mg every 6 hours 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. In cases of β-hemolytic streptococcal infections, treatment should continue for at least 10 days.
The treatment course of clindamycin for streptococcal pharyngitis is:
- Duration: at least 10 days
- Dosage:
- Adults: 150 to 300 mg every 6 hours for serious infections, or 300 to 450 mg every 6 hours for more severe infections
- Pediatric Patients: 8 to 16 mg/kg/day divided into three or four equal doses for serious infections, or 16 to 20 mg/kg/day divided into three or four equal doses for more severe infections 2
From the Research
Treatment Course of Clindamycin for Streptococcal Pharyngitis
- The treatment course of clindamycin for streptococcal pharyngitis typically involves a 10-day regimen, with dosages of 300 mg twice a day (BID) for adults 3 or 20 mg/kg per day, three times a day for 10 days for children 4.
- Clindamycin has been shown to be effective in treating streptococcal pharyngitis, with clinical cure rates of 92.6% at day 12 and 95.4% at 3-month follow-up 3.
- In cases of bacterial treatment failure after penicillin treatment, clindamycin has been found to be an effective alternative, with a 100% eradication rate of group A streptococci in one study 5.
- A shorter course of clindamycin, such as 5-7 days, may also be effective in treating streptococcal pharyngitis, although more research is needed to confirm this 6.
- Clindamycin may be considered as an alternative to tonsillectomy in patients with recurrent group A streptococcal pharyngotonsillitis, as it has been shown to protect patients from recurrence for at least 3 months 7.
Dosage and Administration
- The recommended dosage of clindamycin for streptococcal pharyngitis is 300 mg BID for adults 3 or 20 mg/kg per day, three times a day for 10 days for children 4.
- Clindamycin can be administered orally, and it is recommended to take the medication with food to minimize gastrointestinal side effects.
Efficacy and Safety
- Clindamycin has been shown to be effective in treating streptococcal pharyngitis, with clinical cure rates of 92.6% at day 12 and 95.4% at 3-month follow-up 3.
- Clindamycin is generally well-tolerated, with adverse events reported in 13.8% of patients in one study 3.
- The most common adverse events associated with clindamycin are gastrointestinal, such as diarrhea, which occurs in approximately 8.6% of patients 3.