Infectious Disease Compendium

Clindamycin (Cleocin®)

Dosing

CrCl Formula

CrCl > 80: 150 mg - 900 mg q 6 -8 iv or po.

CrCl 80-50: no change.

CrCl 50-10: no change.

CrCl < 10: no change.

Hemodialysis: no change.

Peritoneal dialysis: no change.

Obesity dosing

Important side effects

#1 cause of C. difficile colitis. Maybe. Quinolones are driving C. difficile of late.

Important drug interactions

Atracurium, cisatracurium, cyclosporine, doxacurium, erythromycin, erythromycin/sulfisoxazole, gallamine, kaolin, metocurine, mivacurium, pancuronium, pipecuronium, rocuronium, tubocurarine, vecuronium.

Rants and Screeds

Pearls

30% of Bacteroides and oral Streptococci are now resistant.

S. aureus resistance in inducible by erythromycin and is used by the lab. When EES induces clindamycin resistance, the will be a 'D' shaped zone on inhibition around the clindamycin (Picture), and so is called the D test (PubMed) Proof that microbiologists are using lots of fermentation products

Treatment of choice

Use to decrease toxin production in all forms of Toxic Shock Syndrome.

Use for

Acne, Anaerobes, Anthrax, Babesia microti, bacterial Endocarditis prophylaxis, Bacterial vaginosis, Bacteroides infections, Diverticulosis/itis, Endometritis, Intraabdominal infections, intraocular infections, Microsporidia, PID, periodontitis, Pneumocystis prophylaxis, and treatment, Staphylococcus aureus, Staphylococcus, coag negative, Streptococci, surgery prophylaxis, Toxoplasma.

Don't use for

Class

Lincosamide.

Last Update: 09/05/19.