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. Adults: Parenteral (IM or IV Administration): Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600 mg to 1,200 mg per day in 2,3 or 4 equal doses More severe infections, particularly those due to proven or suspected Bacteroides fragilis, Peptococcus species, or Clostridium species other than Clostridium perfringens: 1,200 mg to 2,700 mg per day in 2,3 or 4 equal doses.
The recommended clindamycin dosage for septic bursitis is not explicitly stated in the provided drug labels. However, based on the dosage recommendations for serious infections and more severe infections, the following dosages can be considered:
- For adults with serious infections: 150 to 300 mg every 6 hours (PO) or 600 mg to 1,200 mg per day in 2,3 or 4 equal doses (IV/IM)
- For adults with more severe infections: 300 to 450 mg every 6 hours (PO) or 1,200 mg to 2,700 mg per day in 2,3 or 4 equal doses (IV/IM)
- For pediatric patients, the dosage should be based on total body weight, with serious infections requiring 8 to 16 mg/kg/day (PO) or 20 to 40 mg/kg/day (IV/IM), and more severe infections requiring 16 to 20 mg/kg/day (PO) or higher doses as needed (IV/IM) 1 2
From the Research
For septic bursitis, clindamycin is typically dosed at 300-450 mg orally every 6-8 hours for adults, with a total treatment duration of 7-14 days depending on clinical response, as supported by recent studies 3.
Key Considerations
- The most common causative organism in septic bursitis is Staphylococcus aureus, including MRSA, making clindamycin a suitable choice due to its effectiveness against these bacteria 4, 5.
- Treatment should begin promptly after obtaining appropriate cultures, and patients should complete the full course of antibiotics even if symptoms improve quickly to prevent recurrence.
- Adjunctive treatment may include rest, elevation, ice, and possibly drainage of the infected bursa by aspiration or surgical intervention.
- Monitoring for side effects such as diarrhea (including C. difficile infection) is important during treatment.
Dosage and Administration
- Adults: 300-450 mg orally every 6-8 hours, with a total treatment duration of 7-14 days depending on clinical response.
- Children: 10-30 mg/kg/day divided into 3-4 doses.
- In more severe cases, intravenous clindamycin may be initiated at 600-900 mg every 8 hours.
Important Notes
- If no improvement occurs within 48-72 hours, reassessment is necessary to consider alternative antibiotics based on culture results or a different diagnosis.
- Ultrasonography can be useful for assisting in the diagnosis and guiding the aspiration of the infected bursa 3.
- The management of septic bursitis may vary, and controlled trials are needed to establish standardized recommendations regarding antibiotic treatment protocols and the indications of surgery 3.