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