Parenteral Manual

Clindamycin phosphate

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
DALACIN-C®
Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
April 2017
Indications: 
  • Treatment of serious infections due to sensitive anaerobic or gram positive bacteria
  • Bacterial endocarditis prophylaxis for dental and upper respiratory procedures in penicillin-allergic patients.
Reconstitution and Stability: 
  • Stable at room temperature
  • Vial available as 150 mg/mL solution
  • Vial stable 7 days refrigerated once punctured
  • Refrigeration may cause crystallization, which resolubilizes upon warming to room temperature.
  • Infusions of 6 and 12 mg/mL in D5W and 0.9% NaCl stable for 22 days at room temperature, 54 days refrigerated
Compatibility: 

- Solutions Compatible: dextrose up to D10W, 0.9% NaCl, ringer's lactate

- Additives/Above Cassette Compatible: gentamicin, KCl (up to 100 mmol/L)

- Y-site Compatible: morphine, TPN

- Incompatible: aminophylline, tobramycin

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM

YES
Usual dose: < 600 mg

IV Direct

NO

IV Intermittent Infusion

YES
Usual dilution: 12 mg/mL
Infusion time: 30-60 minutes
Infusion rate: do not exceed 30 mg/minute

IV Continuous Infusion YES

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:                         

  • 25-30 mg/kg/day IV ÷  Q 8 hours (Maximum: 1800 mg/day)
  • Severe Infection: 40 mg/kg/day ÷ Q 6 -8 hours (Maximum: 2700 mg/day)  - such as necrotizing fasciitis
  • Refer to CHEO guidelines for - Prevention of Bacterial Endocarditis
                                              - Antimicrobials for Surgical Prophylaxis

Adolescent/Adult:             

  • Usual dose: 1.2-2.7 g/day IV ÷ Q 6-12 hours

    Dosing Interval in hepatic impairment:

  • Half-life increases in moderate to severe liver dysfunction; dosage reductions are recommended; consult Pharmacy for guidelines.
Potential hazards of parenteral administration: 
  • Thrombophlebitis, local erythema, pain and swelling may occur at injection site
  • Hypersensitivity reactions - urticaria and rash
  • Occasional pain or abscess formation after IM injection
  • Hypotension and cardiopulmonary arrest may occur during rapid IV administration; infusion rate should not exceed 30 mg/min
  • Elevation of serum transaminases, transient leukopenia and eosinophilia
  • Clostridium difficile-associated diarrhea and pseudomembranous colitis have occurred
Notes: 
  • Does not cross blood-brain barrier even in the presence of inflamed meninges
  • Discontinue if severe diarrhea occurs; pseudomembranous colitis may develop even up to several weeks following discontinuation of therapy
  • Monitor changes in bowel frequency, CBC, liver and renal function tests

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