ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Lincosamide Antibiotic

Clindamycin 150–300mg oral / 600mg IV

Brand names: Dalacin C

Adult dose

Dose: Oral: 150–450mg every 6h. IV: 600mg every 6–8h (severe infection: 1.2–2.4g/day IV in divided doses).
Route: Oral or IV
Frequency: Every 6–8h
Max: 4.8g/day IV (life-threatening infection — specialist use)
First-line alternative for bone/joint infection in penicillin allergy. Excellent bone penetration. IV-to-oral conversion straightforward (high oral bioavailability ~90%). Duration: as per flucloxacillin — 4–6 weeks for osteomyelitis.

Paediatric dose

Dose: 7.5 mg/kg
Route: Oral or IV
Frequency: Every 6h
Max: 450mg per dose oral; 600mg per dose IV
Concentration: 75 mg/5 mL oral suspension mg/ml
Children: 7.5–15 mg/kg every 6h (oral/IV). Neonates: 3.75–5 mg/kg every 6h (specialist use). High oral bioavailability allows early IV-to-oral switch.

Dose adjustments

Renal

No dose adjustment required

Hepatic

Reduce dose in severe hepatic impairment — primarily hepatic metabolism

Paediatric weight-based calculator

Children: 7.5–15 mg/kg every 6h (oral/IV). Neonates: 3.75–5 mg/kg every 6h (specialist use). High oral bioavailability allows early IV-to-oral switch.

Clinical pearls

  • Preferred alternative in penicillin allergy for bone and joint infections — excellent bone penetration comparable to flucloxacillin
  • CDI risk: warn all patients about diarrhoea; stop immediately and send CDI toxin test if diarrhoea develops during or after course
  • High oral bioavailability (~90%) — IV-to-oral switch appropriate once clinically improving, unlike many antibiotics
  • Also used for community-acquired SSTI (skin and soft tissue infections) and dental prophylaxis in penicillin allergy
  • Clindamycin resistance in Streptococcal infection: check D-zone test (inducible resistance)

Contraindications

  • History of Clostridioides difficile colitis (CDI)
  • Diarrhoeal illness (may mask CDI)
  • Lincosamide hypersensitivity

Side effects

  • Clostridioides difficile-associated diarrhoea/colitis (most significant — class effect)
  • Diarrhoea (common, non-CDI)
  • Nausea
  • Pseudomembranous colitis
  • Metallic taste (IV)
  • Elevated transaminases

Interactions

  • Neuromuscular blocking agents — enhanced neuromuscular blockade
  • Erythromycin — antagonistic (avoid combination)
  • Ciclosporin — levels may be affected

Monitoring

  • Bowel frequency and stool consistency (CDI vigilance)
  • LFTs (prolonged use)
  • CRP/WCC (treatment response)

Reference: BNFc; BNF; BSAC Bone and Joint Infection Guidelines; PHE Guidance on Antibiotic Prescribing. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways