Clindamycin
Mechanism :
Clindamycin is a semisynthetic antibiotic of the group of the parent compound lincomycin.
Indication :
- Staphylococcal infections
- Osteomyelitis
- Septic arthritis
- Peritonitis
- Endocarditis prophylaxis
- Dental infection
- Toxoplasma encephalitis
- Pneumocystis carinii infection
- Falciparum malaria
- Anaerobic infections
Contraindications :
Clindamycin is contraindicated in individuals with a history of hypersensitivity to preparations containing clindamycin or lincomycin.
Dosing :
Neonates:
<7 days <2 kg or >7 days <1200 gm:
10 mg/kg/day IV/IM in 12 hourly divided doses.
<7 days >2 kg or >7 days and 1200-200 gm:
15 mg/kg/day IV/IM in 8 hourly divided doses.
>7 days >2000 gm:
20 mg/kg/day IV/IM in 6 hourly divided doses.
>1 month:
10-25 mg/kg/day PO or 30-40 mg/kg/day IV/IM divided in 6-8 hourly doses. (Max: 1.8 g/day PO, 4.8 gm/day IV/IM) for 5-10 days.
Adverse Effect :
Clostridium difficile colitis, antibiotic-associated colitis, pseudomembranous colitis, abdominal pain, nausea, and vomiting, maculopapular rash, urticaria, hypersensitivity reaction, jaundice, eosinophilia, DRESS syndrome, hypotension.
Interaction :
Neuromuscular Blocking Agents: Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents. Because of possible clinical significance, these two drugs should not be administered concurrently.
Erythromycin: Antagonism has been demonstrated, these two drugs should not be administered concurrently.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function. |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Not dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended. Use with caution in severe hepatic impairment.