Clindamycin is an antibiotic. It works to treat bacterial infections when penicillin is not an option.

Clindamycin is an antibiotic drug. Doctors prescribe clindamycin to treat bacterial infections in certain situations.

The drug comes in several different forms. These are:

  • oral capsules
  • topical creams, lotions, and gels
  • intravaginal suppositories
  • injections and intravenous drips

Depending on the type of infection and the dosage of clindamycin, the drug can either kill or stop the growth of bacteria.

Topical clindamycin is a common treatment option for acne and bacterial infections in the vagina. Doctors also use clindamycin to treat infections in people with penicillin allergies.

Clindamycin is not suitable for everyone, however, and it can cause a range of serious side effects.

This article looks at some uses, dosages, and symptoms of clindamycin. It also explores types and alternatives.

Doctors use clindamycin to treat a variety of bacterial infections. They prescribe it when they cannot use penicillin and when they have determined the type of bacteria involved in the infection.

This is because the form of clindamycin the doctor prescribes depends on the kind of infection the person has.

A doctor may prescribe clindamycin in the form of oral capsules or dissolvable granules for:

  • respiratory infections with streptococci, pneumococci, and staphylococci bacteria
  • empyema, anaerobic pneumonitis, or an abscess in the lung
  • blood poisoning
  • infections from anaerobic bacteria in the gut, resulting in peritonitis or an abscess in the abdomen
  • endometriosis, pelvic cellulitis, an abscess in the reproductive system, or a vaginal cuff infection

A doctor may prescribe intravenous or injectible clindamycin for serious infections, such as:

  • respiratory infections
  • lung infections
  • blood poisoning
  • infections in the reproductive system
  • abdominal infections
  • bone and joint infections, and they may sometimes prescribe it alongside other medications during surgery for chronic bone and joint infections
  • serious skin infections

A doctor may prescribe clindamycin for children as an oral solution to treat:

  • serious respiratory infections
  • serious infections of the skin or soft tissue
  • blood poisoning
  • infections in the abdomen
  • infections in the female reproductive tract

A dermatologist may prescribe clindamycin in the form of a gel, solution, or lotion to treat acne.

A doctor may prescribe clindamycin in the form of a transvaginal suppository to treat bacterial vaginal infections. Alternatively, they may prescribe a clindamycin lotion for vaginal infections. Pregnant people in their second and third trimesters can use the lotion.

Some people can also take clindamycin for uses that the Food and Drug Administration (FDA) has not formally approved. Sometimes, for example, doctors use clindamycin to treat anthrax and malaria.

Dentists also use clindamycin as a preventive treatment for endocarditis, which is an infection of the heart’s lining that can occur after a dental procedure in people who are at risk.

Before having surgery, some people receive clindamycin to prevent surgical site infections.

There are four forms of clindamycin: injectable, intravaginal, oral, and topical.

The following table lists the forms of clindamycin along with their dosages in milligrams (mg), milligrams per milliliter (mg/ml), or percentages.

InjectableIntravaginalOralTopical
clindamycin phosphate injection 6 mg/mlCleocin cream 2%clindamycin capsule 75 mgEvoclin foam 1%
clindamycin phosphate injection 12 mg/mlCleocin suppository
100 mg
clindamycin capsule 150 mgClindagel 1%
clindamycin phosphate injection 18 mg/mlclindamycin capsule 300 mgCleocin T lotion
10 mg/ml
clindamycin phosphate injection 150 mg/mlclindamycin palmitate hydrochloride granules 75 mg/5 mlclindamycin phosphate solution 1%

Dosage for capsules

The dosages for clindamycin capsules for adults are:

  • for serious infections, 150–300 mg every 6 hours
  • for more severe infections, 300–450 mg every 6 hours

The dosages for children who can swallow capsules are:

  • for serious infections, 8–16 mg per kilogram (mg/kg) per day, divided into three or four equal doses
  • for more severe infections, 16–20 mg/kg per day, divided into three or four equal doses

Dosage for suppositories

One suppository pill contains 100 mg of clindamycin. People can use this form once daily at bedtime for 3 consecutive nights.

Dosage for topical gels and lotions

Doctors prescribe Clindagel 1% to be applied once daily to the affected area.

Dosage for injectable clindamycin

The following table includes the dosages for injectable clindamycin in mg/kg per day and mg per day.

Infants (younger than 1 month old)Children and adolescents (ages 1 month to 16 years)People older than 16 years
15–20 mg/kg per day
in 3 or 4 equal doses
20–40 mg/kg per day
in 3 or 4 equal doses
600–1,200 mg per day
in 2, 3, or 4 equal doses
for more severe infections:
1,200–2,700 mg per day
in 2, 3, or 4 equal doses
for life threatening infections:
up to 4,800 mg per day

The form and dosage of clindamycin that a doctor prescribes will depend on the infection a person has.

How to take oral capsules and granules

Doctors should only prescribe clindamycin to people who have allergies to penicillin or if they suspect that a different antibiotic would be inappropriate for that person. This is to lower the risk of colitis, which is inflammation of the colon’s inner lining.

If possible, the doctor should take samples from the infection site to determine which bacteria are causing the infection.

Clindamycin capsules may irritate the esophagus, which is the tube that runs from the mouth to the stomach. To prevent this irritation, people may wish to take clindamycin capsules with a full glass of water.

For people who have difficulty swallowing, clindamycin comes in granules that dissolve in water.

How to use vaginal creams and suppositories

Topical clindamycin can help treat bacterial infections in the vagina.

The cream comes with an applicator. A person can insert the amount of one applicator, which is around 100 mg of clindamycin, into the vagina once daily at bedtime for 3 or 7 consecutive nights.

Cleocin vaginal cream is safe for pregnant people to use in the second and third trimesters. A pregnant person requires 7 days of treatment.

Pregnant people should not use clindamycin vaginal suppositories. Researchers have yet to confirm the safety of suppositories during pregnancy.

To use a suppository, a person can insert one suppository pill — which is equivalent to 100 mg of clindamycin — into the vagina once daily at bedtime for 3 consecutive nights.

People with a history of colitis should not use clindamycin creams or suppositories.

How to use lotions, gels, and solutions

Doctors prescribe clindamycin lotions, gels, and solutions to treat acne.

A person with acne can apply a thin layer of Cleocin T 1% lotion or clindamycin 1% solution to the affected area of skin twice per day.

A person can apply Clindagel 1% once daily to the affected area when acne appears.

Topical clindamycin can cause diarrhea. Anyone who has had colitis should avoid using this treatment.

How to take injectable clindamycin

If a person has a very serious infection and cannot take other antibiotics, they may receive injectable clindamycin at the hospital.

One of the most common side effects of many antibiotics is diarrhea. Sometimes, people experience severe diarrhea when taking clindamycin.

Clindamycin can alter the bacterial composition of the colon and cause an overgrowth of the Clostridium difficile bacterium. This bacterium produces toxins that can cause C. difficile-associated diarrhea (CDAD).

CDAD is a severe and life threatening infection. If a person develops CDAD while taking clindamycin, the doctor will immediately stop their treatment with the antibiotic.

Some other possible side effects of oral or injectable clindamycin include:

People using a clindamycin solution or lotion for acne may report skin-related side effects, including:

For example, when an individual uses Clindagel for acne, the most common side effects are itchiness and skin peeling.

People rarely experience diarrhea or colitis after using clindamycin topically. However, some people do report abdominal disturbances.

Clindamycin suppositories and vaginal creams may cause the same side effects as the oral or injectable forms.

Rarely, a person may develop colitis from using a vaginal clindamycin product.

Some other side effects of using clindamycin suppositories or vaginal creams include:

  • vaginal fungal infections
  • inflammation of the vagina and vulva
  • disorders of the vagina or vulva
  • vaginal pain

People with a history of pseudomembranous or ulcerative colitis should not take clindamycin. These two conditions cause severe inflammation of the lining of the intestine.

The side effects of taking clindamycin can worsen these two conditions.

Doctors should only prescribe clindamycin to people who have bacterial infections. This helps reduce the resistance that bacteria can develop to clindamycin.

Drug interactions may occur when using any form of clindamycin.

Historically, anesthesiologists have worried that clindamycin could delay the effectiveness of neuromuscular blocking agents through surgeries.

More recently, however, researchers have found that the drug may enhance the effect of a blocking agent.

When people take oral forms of clindamycin, the liver enzyme CYP3A4 breaks it down in the body. Stimulating the function of this enzyme can cause a decrease in levels of clindamycin. If something inhibits CYP3A4, clindamycin levels may increase in the blood.

Certain drugs can affect the functioning of CYP3A4. When a person is taking CYP3A4 stimulants along with clindamycin, doctors must follow up and make sure that the antibiotic is working.

If a person is taking an inhibitor of CYP3A4 with clindamycin, the increased levels of the antibiotic may cause side effects. Doctors should monitor any increase in adverse effects.

Clindamycin and lincomycin are the only members of the lincosamide family.

Lincomycin is only available as an injectable solution, and doctors prescribe it for serious infections.

Depending on the infection and the person’s history of allergies and side effects from antibiotics, a doctor may choose another class of antibiotics instead.

Clindamycin is an effective antibiotic for a variety of serious infections. People can also use clindamycin for treating acne.

However, there are many possible side effects of clindamycin. For this reason, doctors should weigh the benefits and risks before prescribing this antibiotic.

People with a history of colitis should avoid taking clindamycin because it could damage their health.

When serious side effects occur, they tend to affect people taking oral or injectable forms of clindamycin. However, they can also arise in people using topical forms.

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