Clindamycin (Cleocin) is an antibiotic used for serious infections caused by susceptible strains of anaerobes, streptococci, staphylococci, pneumococci; reserve use for penicillin-allergic patients or when penicillin is inappropriate; less toxic antibiotics (erythromycin) should be considered.

Generic Names & Brand Names


(klin da mye sin)


clindamycin hydrochloride

Oral: Cleocin, Cleocin Suppository, Dalacin C (CAN)


clindamycin palmitate hydrochloride

Oral: Cleocin Pediatric


clindamycin phosphate

Oral, parenteral, topical dermatologic solution for acne, vaginal preparation:

Cleocin Phosphate, Cleocin T, Cleocin Vaginal Ovules, Clinda-Derm (CAN), Clindagel, ClindaMax, Clindets, Dalacin C (CAN)

Drug class

  • Lincosamide antibiotic
  • Pregnancy Category B

Therapeutic actions

Inhibits protein synthesis in susceptible bacteria, causing cell death.


  • Systemic administration: Serious infections caused by susceptible strains of anaerobes, streptococci, staphylococci, pneumococci; reserve use for penicillin-allergic patients or when penicillin is inappropriate; less toxic antibiotics (erythromycin) should be considered
  • Parenteral: Treatment of septicemia caused by staphylococci, streptococci; acute hematogenous osteomyelitis; adjunct to surgical treatment of chronic bone and joint infections due to susceptible organisms; do not use to treat meningitis; does not cross the blood–brain barrier.
  • Topical dermatologic solution: Treatment of acne vulgaris
  • Vaginal preparation: Treatment of bacterial vaginosis

Contraindications and cautions

Systemic administration

  • Contraindicated with allergy to clindamycin, history of asthma or other allergies, tartrazine (in 75- and 150-mg capsules); hepatic or renal dysfunction; lactation.
  • Use cautiously in newborns and infants due to benzyl alcohol content; associated with gasping syndrome.

Topical dermatologic solution, vaginal preparation

  • Contraindicated with allergy to clindamycin or lincomycin.
  • Use cautiously with history of regional enteritis or ulcerative colitis; history of antibiotic-associated colitis.

Available forms

Capsules—75, 150, 300 mg; granules for oral solution—75 mg/5 mL; injection—150 mg/mL; topical gel—1%; topical lotion—1%; topical suspension—1%; vaginal cream—2%; vaginal suppository—100 mg




150–300 mg q 6 hr, up to 300–450 mg q 6 hr in more severe infections.


600–2,700 mg/day in two to four equal doses; up to 4.8 g/day IV or IM may be used for life-threatening situations.


One applicator (100 mg clindamycin phosphate) intravaginally, preferably at hs for 7 consecutive days; or insert vaginal suppository, preferably at hs for 7 consecutive days, 3 days for Cleocin Vaginal Ovules.


Apply a thin film to affected area bid.



For clindamycin HCl, 8–20 mg/kg/day in three or four equal doses. For clindamycin palmitate HCl, 8–25 mg/kg/day in three or four equal doses; for children weighing < 10 kg, use 37.5 mg tid as the minimum dose.


Neonates: 15–20 mg/kg/day in three or four equal doses.

> 1 mo: 15–40 mg/kg/day in three or four equal doses or 300 mg/m2/day to 400 mg/m2/day; in severe infections, give 300 mg/day regardless of weight.


Reduce dose, and monitor patient’s serum levels carefully.


OralVaries1–2 hr8–12 hr
IM20–30 min1–3 hr8–12 hr
IVImmediateMinutes8–12 hr
TopicalMinimal systemic absorption

Metabolism: Hepatic; T1/2: 2–3 hr

Distribution: Crosses placenta; enters breast milk

Excretion: Urine and feces

IV facts

Preparation: Store unreconstituted product at room temperature. Reconstitute by adding 75 mL of water to 100-mL bottle of palmitate in two portions. Shake well; do not refrigerate reconstituted solution. Reconstituted solution is stable for 2 wk at room temperature. Dilute reconstituted solution to a concentration of 300 mg/50 mL or more of diluent using 0.9% sodium chloride injection, 5% dextrose injection, or lactated Ringer’s solution. Solution is stable for 16 days at room temperature.

WARNING: Infusion: Do not administer more than 1,200 mg in a single 1-hr infusion. Infusion rates: 300 mg in 50 mL diluent, 10 min; 600 mg in 50 mL diluent, 20 min; 900 mg in 50–100 mL diluent, 30 min; 1,200 mg in 100 mL diluent, 40 min. Rapid infusion can cause cardiac arrest.

Incompatibilities: Do not mix with calcium gluconate, ampicillin, phenytoin, barbiturates, aminophylline, and magnesium sulfate. May be mixed with sodium chloride, dextrose, calcium, potassium, vitamin B complex,kanamycin, gentamicin, penicillin, carbenicillin. Incompatible in syringe with tobramycin.

Adverse effects

Systemic administration

  • CV: Hypotension, cardiac arrest (with rapid IV infusion)
  • GI: Severe colitis, including pseudomembranous colitis, nausea, vomiting, diarrhea, abdominal pain, esophagitis, anorexia, jaundice, liver function changes
  • HematologicNeutropenia, leukopenia, agranulocytosis, eosinophilia
  • Hypersensitivity: Rashes, urticaria to anaphylactoid reactions
  • Local: Pain following injection, induration and sterile abscess after IM injection, thrombophlebitis after IV use

Topical dermatologic solution

  • CNS: Fatigue, headache
  • Dermatologic: Contact dermatitis, dryness, gram-negative folliculitis
  • GI: Pseudomembranous colitis, diarrhea, bloody diarrhea; abdominal pain, sore throat
  • GU: Urinary frequency

Vaginal preparation

  • GU: Cervicitis, vaginitis, vulvar irritation


Systemic administration

  • Increased neuromuscular blockade with neuromuscular blocking agents
  • Decreased GI absorption with kaolin, aluminum salts

Nursing considerations


  • History: Allergy to clindamycin, history of asthma or other allergies, allergy to tartrazine (in 75- and 150-mg capsules); hepatic or renal dysfunction; lactation; history of regional enteritis or ulcerative colitis; history of antibiotic associated colitis
  • Physical: Site of infection or acne; skin color, lesions; BP; R, adventitious sounds; bowel sounds, output, liver evaluation; complete blood count, renal and liver function tests


Systemic administration
  • Culture infection before therapy.
  • Administer oral drug with a full glass of water or with food to prevent esophageal irritation.
  • Do not give IM injections of more than 600 mg; inject deep into large muscle to avoid serious problems.
  • Do not use for minor bacterial or viral infections.
  • Monitor renal and liver function tests, and blood counts with prolonged therapy.
Topical dermatologic administration
  • Keep solution away from eyes, mouth and abraded skin or mucous membranes; alcohol base will cause stinging. Shake well before use.
  • Keep cool tap water available to bathe eye, mucous membranes, abraded skin inadvertently contacted by drug solution.
Vaginal preparation
  • Give intravaginally, preferably at hs.

Teaching points

Systemic administration
  • Take oral drug with a full glass of water or with food.
  • Take full prescribed course of oral drug. Do not stop taking without notifying health care provider.
  • You may experience these side effects: Nausea, vomiting (eat frequent small meals); superinfections in the mouth, vagina (use frequent hygiene measures; request treatment if severe).
  • Report severe or watery diarrhea, abdominal pain, inflamed mouth or vagina, skin rash or lesions.
Topical dermatologic administration
  • Apply thin film of acne solution to affected area twice daily, being careful to avoid eyes, mucous membranes, abraded skin; if solution contacts one of these areas, flush with copious amounts of cool water.
  • Report abdominal pain, diarrhea.
Vaginal preparation
  • Use vaginal preparation for 7 or 3 consecutive days, preferably at bedtime. Refrain from sexual intercourse during treatment with this product.
  • Report vaginal irritation, itching; diarrhea, no improvement in complaint being treated.


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