Clindamycin

Indications
 Oral
Severe anaerobic infections
Adult: 150-300 mg every 6 hr. May increase to 450 mg every 6 hr in more severe infections. Max: 1.8 g/day.
Child: 3-6 mg/kg every 6 hr. Children weighing <10 kg should receive at least 37.5 mg every 8 hr.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Oral
Prophylaxis of endocarditis
Adult: 600 mg 1 hr before dental procedure. 300 mg may be given via IV inj (over at least 10 minutes) for high-risk patients undergoing dental procedures involving general anaesthesia.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Intravenous
Severe anaerobic infections
Adult: 0.6-2.7 g daily in divided doses, increased to 4.8 g daily in very severe infections.
Child: >1 mth: 15-40 mg/kg daily in divided doses. A min dose of 300 mg daily should be given regardless of body weight.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Intravenous
Toxic shock syndrome
Adult: 900 mg every 8 hr, in combination with penicillin G or ceftriaxone.
Hepatic impairment: Severe: dosage adjustment may be needed.
Intravenous
Pelvic inflammatory disease
Adult: 900 mg every 8 hr. To be used with gentamicin.
Hepatic impairment: Severe: dosage adjustment may be needed.
Topical/Cutaneous
Acne
Adult: As 1% preparation: Apply a thin layer onto affected area bid.
Renal impairment: Severe: dosage adjustment may be needed.
Vaginal
Bacterial vaginosis
Adult: As pessary or 2% cream: 100 mg once nightly for 3-7 days.
Renal impairment: Severe: dosage adjustment may be needed.
Hepatic impairment: Severe: dosage adjustment may be needed.
Contraindications
 Hypersensitivity.
Warnings / Precautions
 Renal and hepatic diseases; pregnancy and lactation; GI disease; elderly, females, neonates, atopic patients. Regular monitoring of blood counts, liver and kidney functions.
Adverse Reactions
 Diarrhoea, nausea, vomiting, abdominal pain; erythema multiforme, contact dermatitis, exfoliative and vesiculous dermatitis, urticaria; eosinophilia; local irritation, thrombophloebitis.
Potentially Fatal: Gasping syndrome (neonates); pseudomembranous colitis.
Overdose Reactions
 Dialysis or peritoneal dialysis unlikely to be helpful.
Drug Interactions
 Antagonises effects of parasympathetics.
Potentially Fatal: Respiratory depression with neuromuscular blockers.
See Below for More clindamycin Drug Interactions
Food Interactions
 May reduce rate of absorption.
Mechanism of Actions
 Clindamycin inhibits protein synthesis by reversibly binding to the 50S subunit of the ribosomal thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting to stunted cell growth.
Absorption: 90% absorbed from the GI tract (oral), absorbed from the skin (topical), systemically (intravaginal); rate of absorption may be reduced by the presence of food.
Distribution: Body tissues and fluids (wide), bone, bile (high concentrations), leukocytes, macrophages; crosses the placenta and enters breast milk. Protein-binding: >90%
Metabolism: Hepatic; converted to N-demethyl and sulfoxide metabolites and some inactive metabolites.
Excretion: Via urine (10% as active drug or metabolites), via faeces (4% as inactive metabolites); 2-3 hr (elimination half-life), may be prolonged in preterm neonates and severe renal impairment.
Administration
 Granules: Should be taken with food.
Cap: May be taken with or without food. (Swallow whole w/ a full glass of water & in an upright position.)
Storage Conditions
 Intravenous: Store at 20-25°C. Oral: Store at 20-25°C. Topical/Cutaneous: Store at 20-25°C. Vaginal: Store at 20-25°C.
ATC Classification
 D10AF01 - clindamycin ; Belongs to the class of topical antiinfective preparations used in the treatment of acne.
G01AA10 - clindamycin ; Belongs to the class of antibiotics. Used in the treatment of gynecological infections.
J01FF01 - clindamycin ; Belongs to the class of lincosamides. Used in the systemic treatment of infections.
Storage
 Intravenous: Store at 20-25°C. Oral: Store at 20-25°C. Topical/Cutaneous: Store at 20-25°C. Vaginal: Store at 20-25°C.
Available As
  • Clindamycin Phosphate 0.1%
  • Clindamycin 1%
  • Clindamycin Phosphate 1%
  • Clindamycin 1% w/v
  • Clindamycin 1% w/w
  • Clindamycin Phosphate 1% w/w
  • Clindamycin 1.0%
  • Clindamycin 1.0% w/w
  • Clindamycin Phosphate 1.0% w/w
  • Clindamycin Phosphate 1.00% w/w
  • Clindamycin 10 mg
  • Clindamycin Phosphate 10 mg
  • Clindamycin Phosphate 100 mg
  • Clindamycin 100 mg
  • Clindamycin 150 mg
  • Clindamycin 20 gm
  • Clindamycin 200 mg
  • Clindamycin 300 mg
  • Clindamycin 50 gm

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