Dosing
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.
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.