Clindamycin is effective in treating a wide range of infections caused by susceptible anaerobic bacteria and certain gram-positive organisms such as streptococci, staphylococci, and pneumococci. It is indicated for upper and lower respiratory tract infections, skin and soft tissue infections, bone and joint infections, pelvic infections, intra-abdominal infections, septicemia, endocarditis, and dental infections. Additionally, it may be used as an alternative therapy in combination with quinine or amodiaquine for the treatment of multidrug-resistant Plasmodium falciparum malaria.

Clindamycin is a lincosamide class antibiotic used for treating infections caused by susceptible bacteria. It is a semi-synthetic derivative of lincomycin.

Microbial Spectrum:

▪ Aerobic gram-positive cocci: Staphylococcus aureus, Staphylococcus epidermidis (including penicillinase and non-penicillinase producing strains), Streptococci, Pneumococci
▪ Anaerobic gram-negative bacilli: Bacteroides species, Fusobacterium species
▪ Anaerobic gram-positive non-spore-forming bacilli: Propionibacterium species, Eubacterium species, Actinomyces species
▪ Anaerobic and microaerophilic gram-positive cocci: Peptococcus species, Peptostreptococcus species, microaerophilic streptococci, Clostridium perfringens

Dosage of Clindamycin Capsule:

• Serious Infections: 150 mg-300 mg every six hours.
• More severe infections: 300 mg-450 mg every six hours.

To avoid the possibility of oesophageal irritation, Clindacin capsules should be taken with a full glass of water.

Several researches has found that Clindamycin 300 mg capsule provides plasma concentration over MIC90 for more than 12 hours. This finding supports the twice-daily dosing of Clindacin 300 mg capsule, particularly in SSTIs & RTIs. However, in case of bone & joint infections, diabetic foot infections dose of Clindamycin should be 300 mg capsule 3-4 times daily.

Dosage of Clindamycin Powder for oral solution:

• Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.
• Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.
• More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.

In pediatric patients weighing 10 kg or less, 1/2 teaspoon (37.5 mg) three times a day should be considered the minimum recommended dose.

Dosage of Clindamycin IV/IM injection:
Adults:

• Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes: 600-1200 mg/day in 2- 4 equal doses.
• More severe infections: 1200-2700 mg/day in 2-4 equal doses.
• For more serious infections: these doses may have to be increased. In life-threatening situations due to either aerobes or anaerobes, these doses may be increased.
• Doses of as much as 4800 mg daily have been given intravenously to adults. Single intramuscular injections of greater than 600 mg are not recommended.

Neonates (less than 1 month): 15 to 20 mg/kg/day in 3 to 4 equal doses. The lower effective dosage may be adequate for small prematures.

Pediatric patients (1 month of age to 16 years):

• 20 to 40 mg/kg/day in 3 or 4 equal doses. The higher doses would be used for more severe infections.
• Parenteral therapy may be changed to Capsules (clindamycin hydrochloride) when the condition warrants and at the discretion of the physician.
• In cases of (3-hemolytic streptococcal infections, treatment should be continued for at least 10 days.

Clindamycin may potentiate the effects of neuromuscular blocking agents; therefore, caution is advised when used concurrently. An antagonistic interaction has been observed between clindamycin and erythromycin in vitro, and due to possible clinical relevance, these two drugs should not be administered together.

Clindamycin should not be used in patients who have previously shown hypersensitivity to clindamycin or any component of this medicine.

Reported adverse effects include abdominal pain, esophagitis, esophageal ulcer, nausea, vomiting, diarrhea, itching, skin rash, and urticaria.

Pregnancy Category B: Clindamycin crosses the placenta, and amniotic fluid levels may reach approximately 30% of maternal plasma concentrations after repeated dosing. It should be used during pregnancy only when clearly necessary. Clindamycin is excreted in breast milk; therefore, use in nursing mothers is not recommended unless essential.

Clindamycin should be used cautiously in patients with a history of gastrointestinal disorders, especially colitis.

Use in newborns and infants: When used in neonates and infants, careful monitoring of organ function is recommended.

Geriatric use: No dose adjustment is generally required in elderly patients.

Overdose with oral clindamycin is uncommon. Adverse effects similar to normal dosing may occur, although unexpected reactions are possible. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin. Management includes supportive care and gastric lavage if necessary. No specific antidote is available.

Clindamycin belongs to the Macrolide antibiotic class.

Store clindamycin in a cool place below 30°C, protected from light and moisture. Always keep it out of the reach of children.