Antimicrobials
Clindamycin

Clindamycin

Restricted

High
Excellent

Spectrum of Activity

Dosing

General Information

Administration

  • Deep IM site, rotate sites and not to exceed 600mg in a single injection
  • Never administered as bolus
  • IV infusion over 10-60 minutes (max. rate 30mg/min)
  • PO capsule taken with full glass of water to prevent esophageal irritation
  • Shake oral suspension well before use
  • PO dose with or without food

Preparation

  • Dilute vials with 50-100mL of D5W or NS
  • Final IV concentration not to exceed 18mg/mL

Compatibility

  • D5W, NS, or LR

Anaerobic infections above the diaphragm, especially dental infection.

Gram positive skin and soft tissue infections including necrotizing fasciitis as an adjunctive agent to a beta lactam for reducing toxin production.

Skin & soft tissue infections involving susceptible MRSA.

Susceptible infections and surgical prophylaxis in setting of IgE mediated beta-lactam allergy.

For decreasing toxin production in toxic shock syndrome.

Tier 3 Protected Antimicrobial

  • Limited to use for the listed indications. For all other indications, the antimicrobial must be ordered by an ID physician or an ID consult placed.
  • Prospective audit with feedback with provided by ASP/Pharmacy and utilization/compliance reported quarterly.

AHS Use Criteria:

  • Suspected or confirmed necrotizing gram-positive infection
  • Allergy to all alternative antibiotics, last-line option
  • Culture proven sensitivity

Monitor for diarrhea and test for C. diff if indicated

If severe liver dysfunction, test liver function periodically

Monitor CBC, liver and renal function with prolonged use

  • Metallic taste (IV)
  • Thrombophlebitis
  • Skin rash
  • Abdominal pain
  • Oliguria, proteinuria
  • Abscess at injection site (IM)

Muscle relaxants, e.g., atracurium, mecamylamine, baclofen, diazepam.

  • enhanced neuromuscular blocking

CYP3A4 inducers (strong): St. Johns Wort

  • decrease Clindamycin concentration

Mycophenolate: decreased mycophenolate concentrations

Antimicrobial class: Lincosamide

Pregnancy category: B

Average serum half life: 2.4 hours

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Poor, even with inflamed meninges

Biliary penetration: Therapeutic