Antimicrobials
Clindamycin

Clindamycin

High
Excellent (90 to 100%)
$ (<$25/day)

Spectrum of Activity

Dosing

General Information

  • In severe liver disease, monitor LFTs periodically
  • Metallic taste (IV)
  • Thrombophlebitis
  • Skin rash
  • Abdominal pain
  • Oliguria, proteinuria

Major substrate of CYP3A4

  • Absorption: Oral, hydrochloride: Rapid (90%); clindamycin palmitate must be hydrolyzed in the GI tract before it is active
  • Distribution: Distributed in body fluids and tissues; no significant levels in CSF, even with inflamed meninges
  • Protein binding: 94%
  • Metabolism: Biologically inactive clindamycin phosphate (intravenous formulation) is rapidly converted to active clindamycin. Clindamycin is metabolized predominantly by CYP3A4, with minor contribution by CYP3A5, to form clindamycin sulfoxide (major metabolite) and N-desmethylclindamycin (minor metabolite)
  • Bioavailability: Oral: ~90%
  • Half-life elimination: 3 hrs
  • Excretion: Urine (~10%) and feces (3.6%) as active drug and metabolites
  • Currently on formulary
  • Formulations:
    • 150 mg capsule
    • 300 mg capsule
    • 15 mg/mL oral liquid