Prescribing and Administration Monographs

General Information

Clinical Guidelines and Protocols

Antimicrobial Guidelines

Disclaimer



Clindamycin       Renal    €€     Hepatic   




Clindamycin



Aliases:

Registered Trademarks: Dalacin®

Warnings: Hepatic, Renal, €€

Dosage:

Neonates:

Oral dose:

< 14 days: 3-6mg/kg PO 8 hourly 
14-28 days: 3–6mg/kg PO 6 hourly 
Clindamycin injection contains benzyl alcohol, which has been associated with a fatal ‘gasping syndrome’ in premature infants.

Over one month:

IV dose: 6 –10mg/kg IV 6-8 hourly    
Usual adult dose: 150–900mg IV 8 hourly. Doses up to 4.8g daily in 3-4 divided doses may be used in severe infection; Max single IV dose 1.2g. 

Oral dose: 
6 –10mg/kg PO 6 - 8 hourly (maximum adult dose: 450mg PO 6 hourly)
If < 10kg, minimum dose is 37.5mg 8 hourly PO 
Usual adult dose: 150 – 300 mg PO 6 hourly


Monitoring:

Monitor LFTS and renal function in neonates or if treatment exceeds 10 days.


Administration:

Intravenous Infusion: Clindamycin 150mg/mL injection available as Dalacin C® or Fresenius Kabi brand 300mg/2mL, 600mg/4mL (contain benzyl alcohol 9mg/mL) 

Compatible Infusion Fluids: Sodium Chloride 0.9%w/v or Glucose 5%w/v

Concentration for Infusion:
In areas with access to the CHI Smart-pump Standard Concentration Infusion (SCI) drug library:

In areas without access to the CHI Smart pump Standard Concentration Infusion (SCI) drug library: Dilute to a concentration of 6mg/mL. If patient is fluid-restricted, may be diluted to maximum concentration of 18mg/mL.

Method of Administration: IV infusion over 10-60 minutes. Maximum rate of infusion 20mg/kg/hour. Doses of 1.2g must be infused over 60 minutes. 

Oral:
Capsules should be swallowed with plenty of water to avoid oesophageal ulceration. 
Contents of capsules may be dispersed in water or juice if oral suspension is not available.


Interactions:

May enhance the action of neuromuscular blocking agents 

Enhanced anticoagulant effect with Warfarin - monitor INR

Clindamycin metabolised may be affected by enzyme inducers / inhibitors. Please see SPC (link below) for details.

This list is not exhaustive see SPC for full details www.hpra.ie


Adverse Effects:

GI disturbances, blood dyscrasias, altered LFTs, pruritus, allergic reactions, pseudomembranous colitis

This list is not exhaustive see SPC for full details www.hpra.ie


Preparations:

Clindamycin Injection 150mg/mL: Dalacin C® or Fresenius Kabi 300mg/2mL, 600mg/4mL (contains benzyl alcohol 9mg/mL)
Dalacin C® Capsules 150mg
Dalacin C® Suspension 75mg/5mL (unlicensed) 




Neonates:

Oral dose:

< 14 days: 3-6mg/kg PO 8 hourly 
14-28 days: 3–6mg/kg PO 6 hourly 
Clindamycin injection contains benzyl alcohol, which has been associated with a fatal ‘gasping syndrome’ in premature infants.

Over one month:

IV dose: 6 –10mg/kg IV 6-8 hourly    
Usual adult dose: 150–900mg IV 8 hourly. Doses up to 4.8g daily in 3-4 divided doses may be used in severe infection; Max single IV dose 1.2g. 

Oral dose: 
6 –10mg/kg PO 6 - 8 hourly (maximum adult dose: 450mg PO 6 hourly)
If < 10kg, minimum dose is 37.5mg 8 hourly PO 
Usual adult dose: 150 – 300 mg PO 6 hourly




Monitor LFTS and renal function in neonates or if treatment exceeds 10 days.




Intravenous Infusion: Clindamycin 150mg/mL injection available as Dalacin C® or Fresenius Kabi brand 300mg/2mL, 600mg/4mL (contain benzyl alcohol 9mg/mL) 

Compatible Infusion Fluids: Sodium Chloride 0.9%w/v or Glucose 5%w/v

Concentration for Infusion:
In areas with access to the CHI Smart-pump Standard Concentration Infusion (SCI) drug library:

In areas without access to the CHI Smart pump Standard Concentration Infusion (SCI) drug library: Dilute to a concentration of 6mg/mL. If patient is fluid-restricted, may be diluted to maximum concentration of 18mg/mL.

Method of Administration: IV infusion over 10-60 minutes. Maximum rate of infusion 20mg/kg/hour. Doses of 1.2g must be infused over 60 minutes. 

Oral:
Capsules should be swallowed with plenty of water to avoid oesophageal ulceration. 
Contents of capsules may be dispersed in water or juice if oral suspension is not available.




May enhance the action of neuromuscular blocking agents 

Enhanced anticoagulant effect with Warfarin - monitor INR

Clindamycin metabolised may be affected by enzyme inducers / inhibitors. Please see SPC (link below) for details.

This list is not exhaustive see SPC for full details www.hpra.ie




GI disturbances, blood dyscrasias, altered LFTs, pruritus, allergic reactions, pseudomembranous colitis

This list is not exhaustive see SPC for full details www.hpra.ie




Clindamycin Injection 150mg/mL: Dalacin C® or Fresenius Kabi 300mg/2mL, 600mg/4mL (contains benzyl alcohol 9mg/mL)
Dalacin C® Capsules 150mg
Dalacin C® Suspension 75mg/5mL (unlicensed) 




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