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Clindamycin (Cleocin)

Category:

  • Antibiotic

Description:

  • Lincosamide antibiotic

Indications:

  • Anaerobic infections (empyema, lung abscesses, intra-abdominal infections and absecesses, peritonitis, endometriosis)

  • Streptococci and Staphylococci infections (serious respiratory and skin infections, septicemia, osteomyelitis)

  • Pneumococci infections (respiratory infections)

  • Adjunctive therapy to surgical treatment of bone and joint infections

  • Dental procedure prophylaxis

  • Unlabeled uses:

  • CNS toxoplasmosis in AIDS patients

  • Pneumocystis carinii

  • Pelvic Inflammatory Disease: Chlamydia trachomatis

  • Bacterial vaginitis: Gardnerella vaginalis

Contraindications:

  • May cause a fatal colitis, characterized by severe diarrhea, cramping, and passage of blood and mucous

  • Not for treatment of minor bacterial or viral infections

Precautions:

  • Pregnancy category B

  • Risk of fatal colitis

  • Does not adequately diffuse into CSF, therefore not for meningitis therapy

  • Clindamycin crosses into breast milk

  • Closely monitor organ system functions when administering to newborns and infants

  • Monitor liver/kidney functions and blood counts if administering for prolonged periods

  • DO NOT administer as an IV bolus, infuse over 10-60 minutes

Adverse Reactions (Side Effects):

  • Hypotension

  • CNS: Headache, mild depression, confusion

  • Gastrointestinal: diarrhea (2-20%), pseudomembranous colitis (>10% with oral tx), nausea, vomiting, abdominal pain, esophagitis

  • Jaundice

  • Local injection site pain, thrombophlebitis

  • Hypersensitivity reactions: urticaria, erythema multiforme, generalized morbilliform-like rash

  • Take each dose with a full glass of water (decreases esophageal iritiation)

  • May be taken without regard for meals

  • Complete full course of therapy

Dosage:

  • Administered orally (capsules and solution) and deep IM or IV injection

  • Adults:

    • 150-300mg every 6 hours

  • serious infections:

    • 300-450mg every six hours

  • CNC toxoplasmosis: 

    • 1200-2400mg/day with pyrimethamine

  • Pelvic Inflammatory Disease: 

    • 900mg every 8 hours IV with gentamicin (LD: 2mg/kg IV followed by 1.5mg/kg every 8 hours IV), therapy continued for 24 hours after patient improvement

  • Pneumocystis carinii

    • 600mg qid IV or 900mg tid IV with primaquine

  • Bacterial vaginitis: 

    • 300mg bid for 7 days

  • Children:

    • 8-16mg/kg/day in divided doses three to four times a day

    • serious infections: 16-20mg/kg/day in divided doses three to four times a day

  • Parenteral:

    • Adults (>16 years old):

    • Aerobic gram-positive cocci and sensitive anaerobes: 600-1200mg/day in 2-4 equal doses

    • B. fragilis, Peptococcus species or Clostridium species: 1.2-2.7grams per day in 2-4 equal doses

    • Life-threatening situations: 4.8 grams per day

  • Children (>1 month):

    • 20-40mg/kg/day divided into 3-4 equal doses

  • Neonates (<1 month):

    • 15-20mg/kg/day in 3-4 divided doses

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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