How to Take Clindamycin
Oral Administration Guidelines
Clindamycin capsules should be taken with a full glass of water to avoid esophageal irritation, and the dosing frequency depends on infection severity. 1
Standard Adult Dosing
- For serious infections: Take 150-300 mg every 6 hours (four times daily) 1
- For more severe infections: Take 300-450 mg every 6 hours (four times daily) 1
- For complicated skin and soft tissue infections or MRSA: The preferred dose is 300-450 mg four times daily, which supersedes lower FDA-labeled dosing based on superior clinical outcomes 2
Dosing Frequency Considerations
- The every 6-hour (four times daily) schedule is essential for maintaining therapeutic drug levels, as clindamycin has a relatively short half-life of 2-3 hours requiring frequent dosing 3
- An every 8-hour (three times daily) schedule at 600 mg per dose has been shown to be equally effective as every 6-hour dosing in hospitalized patients, with no difference in clinical outcomes 4
- Do not use once or twice daily dosing—clindamycin pharmacokinetics do not support extended-interval dosing 2
Administration Instructions
- Always take with a full glass of water to prevent esophageal irritation 1
- Capsules must be swallowed whole—they are not suitable for patients who cannot swallow capsules intact 1
- Clindamycin can be taken with or without food, as oral absorption is nearly complete (>90%) regardless of food intake 3
- Peak serum levels are reached in 45-60 minutes after oral administration 3
Pediatric Dosing (for children who can swallow capsules)
- For serious infections: 8-16 mg/kg/day divided into three or four equal doses 1
- For more severe infections: 16-20 mg/kg/day divided into three or four equal doses 1
- For MRSA or Group A Streptococcus: 30-40 mg/kg/day divided into 3-4 doses 2
- Clindamycin should be dosed based on total body weight regardless of obesity 1
Duration of Treatment
- For β-hemolytic streptococcal infections: Continue treatment for at least 10 days 1
- For most skin and soft tissue infections: 7 days is typically sufficient 2
- For complicated infections: 7-14 days depending on clinical response 2
- For Group A Streptococcus pharyngeal carriage eradication: 300 mg four times daily for 10 days 5
Critical Warnings
- Discontinue immediately if significant diarrhea occurs during therapy, as this may indicate pseudomembranous colitis 1
- The maximum single oral dose should not exceed 600 mg 2
- For children unable to swallow capsules, use clindamycin palmitate oral solution instead, as capsules do not provide exact mg/kg doses 1
Common Pitfalls to Avoid
- Underdosing serious infections: Using 150 mg doses when 300-450 mg four times daily is indicated for MRSA or complicated infections can lead to treatment failure 2
- Inadequate water intake: Failing to take with a full glass of water increases risk of esophageal irritation 1
- Premature discontinuation: Stopping before completing the full course, especially in streptococcal infections requiring minimum 10 days 1
- Using clindamycin when local MRSA resistance rates exceed 10%: This significantly increases treatment failure risk 2