Clindamycin Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• Consider intravenous to oral switch as soon as possible as excellent bioavailability ^{(ref 1)}
• The appearance of persistent diarrhoea should be regarded as an indication that clindamycin should be discontinued immediately.

Available preparations

Clindamycin 600mg per 4ml ampoule (Fresenius Kabi)

Clindamycin 300mg per 2ml ampoule (Fresenius Kabi)

Dalacin C Phosphate 300mg per 2ml ampoule

Dalacin C Phosphate 600mg per 4ml ampoule

Reconstitution

Already in solution

Draw up using a 5 micron filter needle

Dilute further prior to administration

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Intermittent intravenous infusion

Dose	Diluent	Duration of infusion
300mg	50mL*	over at least 10 minutes
600mg	50mL*	over at least 20 minutes
900mg	50 to 100mL	over at least 30 minutes
1200mg	100mL	over at least 40 minutes
i.e. maximum rate of administration 30mg per minute, maximum concentration 18mg per mL
* 50mL volumes: the residual volume in the infusion line must be flushed through at the same rate to avoid significant underdosing
Fluid restricted: maximum concentration 18mg/mL. Each 300mg in minimum 17mL infusion fluid

Dose in adults

Usual dose ^{(ref 1) -}

• Give 600mg every eight hours
• See below for higher doses for specific situations

Life-threatening infections e.g.Necrotising fasciitis/gas gangrene (Group A Streptococcal infection) Discuss with Microbiology or Infectious Diseases ^{(ref 1)}

• Give 1.2g every six hours

Pelvic inflammatory disease (penicillin allergy) ^{(ref 1)}

• Give 900mg every eight hours

Pyelonephritis in pregnancy (penicillin allergy)^{(ref 1)}

• Give 900mg every eight hours (in combination with other agents)

Peri-tonsillar abscess (where penicillin allergy: immediate or severe delayed reaction) ^{(ref 1)}

• Give 600mg to 900mg every eight hours

Monitoring

• If treatment extends to greater than 10 days monitor renal function, hepatic function and FBC

Storage

• Store below 25⁰C
• Do not refrigerate

References

SPC for Dalacin C October 2024

SPC for Fresenius Kabi product October 2021

1. Antimicrobial Prescribing Guidelines for GUH

Therapeutic classification

Antibiotic