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 (oral/IV), Dalacin T (topical)

Used in: Cellulitis & Skin Infection

Clindamycin is a lincosamide antibiotic used for some skin and soft-tissue, dental, bone and joint, and anaerobic infections, often as a penicillin alternative.

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 also suppresses toxin production in some severe streptococcal and staphylococcal infections.

Prescribing in practice

It carries a notably high risk of Clostridioides difficile infection — stop it and investigate significant diarrhoea.
It penetrates bone well and is useful in penicillin allergy for relevant organisms.
Use caution in severe hepatic impairment; it is usually avoided where narrower options suffice.

Monitoring

Short courses need no routine monitoring; remain alert to diarrhoea, and consider liver function with prolonged use.

Counselling the patient

Stop it and seek advice if you develop significant or watery diarrhoea.
Complete the course.
Take capsules with a full glass of water.

Evidence & guidelines

Used for specific infections and as a penicillin alternative per local guidance, with a high C. difficile risk to weigh.

Reference: IDSA SSTI Guidelines; C. difficile risk stratification; 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.

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