Lincosamide antibiotic Pregnancy: Clindamycin crosses the placenta; systemic use in second and third trimesters not associated with increased congenital abnormalities, but no adequate controlled studies in first trimester. Use in pregnancy only if clearly needed.

Clindamycin

Brand names: Dalacin C, Dalacin T

Clindamycin is a lincosamide antibiotic for selected skin/soft-tissue, dental, bone and anaerobic infections, and is useful in penicillin allergy.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 150-300 mg

Route: oral

Frequency: every six hours

Max: 450 mg every six hours (severe infection)

Moderately severe infection: 150-300 mg every six hours. Severe infection: 300-450 mg every six hours. Capsules should always be swallowed whole with a full glass of water in an upright position, at least 30 minutes before lying down (oesophageal irritation risk); absorption not appreciably modified by food. Elderly: dosage should not be influenced by age alone. In beta-haemolytic streptococcal infection, continue for at least 10 days. Dosage modification not necessary in renal or hepatic insufficiency. Source: Clindamycin 150 mg Capsules SPC.

Paediatric dose

Route: oral

Frequency: six hourly (divided)

12-25 mg/kg/day (divided six hourly) depending on severity of infection; dose based on total body weight regardless of obesity. Capsules should only be used for children able to swallow capsules; whole capsules may not provide exact mg/kg doses required. Verify against a children's formulary.

Dose adjustments

Renal

Dosage modification is not necessary in patients with renal (or hepatic) insufficiency.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Apply a thin film of clindamycin phosphate topical lotion twice daily to affected area. Lotion: Shake well immediately before using. Keep all liquid dosage forms in containers tightly closed.

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-03-22. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Contraindications

Previous sensitivity to clindamycin or lincomycin, or to any of the excipients

Side effects

Abdominal pain
Diarrhoea
Pseudomembranous / Clostridium difficile colitis
Maculopapular rash, urticaria
Jaundice / abnormal liver function tests

Interactions

Neuromuscular blocking agents - clindamycin may enhance their action (use with caution)

Clinical monograph

How it works

It inhibits bacterial protein synthesis at the 50S ribosomal subunit and reduces toxin production in some streptococcal and staphylococcal infections.

Prescribing in practice

It is strongly associated with Clostridioides difficile colitis — stop it and investigate significant or bloody diarrhoea.
It has good oral bioavailability and bone penetration.
It can cause oesophageal irritation — take capsules with plenty of water.

Monitoring

Watch for diarrhoea and review the clinical response.

Counselling the patient

Report severe, watery or bloody diarrhoea promptly — do not simply take anti-diarrhoeal medicines.
Take capsules with a full glass of water.

Evidence & guidelines

Used per local guidance for the above indications, with the important C. difficile caution.

Reference: NICE CKS; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

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