Dalacin/Dalacin C

Clindamycin (Cap: HCl; Soln for inj: phosphate)

Susceptible infections caused by anaerobic bacteria, strains of gm +ve aerobic bacteria (eg, Strep, Staph & Pneumococci) & Chlamydia trachomatis eg, upper & lower resp tract, skin & soft tissue, non-limb- & limb-threatening diabetic foot, bone & joint, gynecological, intra-abdominal & dental infections; septicemia & endocarditis; toxoplasmic encephalitis in combination w/ pyrimethamine & Pneumocystis jirovecii pneumonia in patients w/ AIDS; malaria including multi-resistant Plasmodium falciparum in combination w/ quinine. Prophylaxis of endocarditis in patients sensitive/allergic to penicillins; neck & head surgery infection. In combination w/ aminoglycoside (eg, gentamicin or tobramycin) for preventing peritonitis or intra-abdominal abscess after bowel perforation & bacterial contamination secondary to trauma.

β-hemolytic streptococcal infections Continue treatment for at least 10 days. Toxoplasmic encephalitis in patients w/ AIDS 600-1,200 mg IV/PO every 6 hr for 2 wk followed by 300-600 mg PO every 6 hr + pyrimethamine 25-75 mg PO daily for 8-10 wk. Give folinic acid 10-20 mg daily for higher doses of pyrimethamine. Duration of therapy: 8-10 wk. Pneumocystis carinii pneumonia in patient w/ AIDS 600-900 mg IV every 6 hr or 900 mg IV every 8 hr or 300-450 mg PO every 6 hr for 21 days + primaquine 15-30 mg PO once daily for 21 days. Cap Adult 600-1,800 mg daily divided in 2, 3, or 4 equal doses. Childn >1 mth who are able to swallow cap 8-25 mg/kg daily in 3 or 4 equal doses. Mild/moderate diabetic foot infections 300 mg tid-qid for 7-14 days. Chlamydia trachomatis cervicitis 450-600 mg qid for 10-14 days. Acute streptococcal tonsilitis/pharyngitis 300 mg bid for 10 days. Uncomplicated malaria/Plasmodium falciparum Quinine sulfate 650 mg (in adult) or 10 mg/kg (in childn) tid for 3-7 days + clindamycin 20 mg/kg daily divided tid for 7 days. Severe malaria Adult Quinidine gluconate 10 mg/kg IV as loading dose over 1-2 hr, then 0.02 mg/kg/min continuous infusion for at least 24 hr. Once parasite density <1% & patient can take oral medication, complete treatment w/ the same dose of oral quinine in uncomplicated malaria + clindamycin 20 mg/kg daily divided tid for 7 days. If patient cannot take oral medication, give clindamycin 10 mg/kg loading dose IV followed by 5 mg/kg IV every 8 hr. Switch to oral clindamycin as soon as patient can take oral medication. Treatment course: 7 days. Childn Same quinidine gluconate adult dose + oral clindamycin 20 mg/kg daily divided tid for 7 days. If patient cannot take oral medication, give clindamycin 10 mg/kg loading dose IV followed by 5 mg/kg IV every 8 hr. Switch to oral clindamycin as soon as patient can take oral medication. Treatment course: 7 days. Prophylaxis of endocarditis in patients sensitive to penicillin 600 mg (in adult) or 20 mg/kg (in childn) 1 hr before procedure. Alternatively, 600 mg IV 1 hr before procedure when parenteral administration is required. Soln for inj Administer IM as undiluted. Administer IV as diluted then infuse over at least 10-60 min. The conc of clindamycin in diluent for infusion should not exceed 18 mg/mL & infusion rates should not exceed 30 mg/min. Adult Intra-abdominal, female pelvis, other complicated & serious infections 2,400-2,700 mg IM/IV given in 2, 3, or 4 equal doses. Less complicated infections due to more susceptible microorganisms 1,200-1,800 mg IM/IV daily given in 2, 3, or 4 equal doses. Max daily dose: 4,800 mg. Childn >1 mth 20-40 mg/kg daily in 3 or 4 equal doses. Neonates (<1 mth) 15-20 mg/kg daily in 3 or 4 equal doses. Pelvic inflammatory disease 900 mg IV every 8 hr + IV antibiotic w/ appropriate gm -ve aerobic spectrum. Continue IV for at least 4 days & at least 48 hr after improvement, then continue w/ clindamycin 450-600 mg PO every 6 hr to complete 10-14 days total therapy. Prophylaxis of infection in head & neck surgery 900 mg diluted in 1,000 mL normal saline as intraoperative irrigant in contaminated head & neck surgery prior to wound closure.

May be taken with or without food: Swallow whole w/ a full glass of water, no less than 30 minutes before lying down to avoid oesophageal irritation.

Hypersensitivity to clindamycin or lincomycin.

Discontinue treatment if hypersensitivity or severe skin reaction (eg, DRESS, SJS, TEN & acute generalized exanthematous pustulosis) occurs. Not to be used in treatment of meningitis. Pseudomembranous & antibiotic-associated colitis; Clostridioides difficile-associated diarrhea; acute kidney injury including acute renal failure. Consider fluid & electrolyte management, protein supplementation & antibacterial treatment effective against Clostridioides difficile colitis in moderate to severe cases of pseudomembranous colitis. Perform LFTs for prolonged therapy. Monitor renal function during therapy in patients w/ pre-existing renal dysfunction or taking concomitant nephrotoxic drugs & if therapy is prolonged. Pregnancy & lactation. Cap: Risk of oesophagitis & oesophageal ulcer. Soln for inj: Not to be inj IV undiluted as bolus. Not to administer >1,200 mg by IV infusion in single 1-hr period. Not recommended to administer single IM doses >600 mg. Overgrowth of non-susceptible organisms, particularly yeasts. Gasping syndrome in premature & low birth wt infants due to benzyl alcohol content.

Pseudomembranous colitis; eosinophilia; thrombophlebitis; diarrhea; maculopapular rash; abnormal LFT. TEN, SJS, DRESS.

Enhanced action of neuromuscular blocking agents. Reduced clearance w/ CYP3A4 & CYP3A5 inhibitors. Increased clearance w/ CYP3A4 (eg, rifampicin) & CYP3A5 inducers.

Other Antibiotics

J01FF01 - clindamycin ; Belongs to the class of lincosamides. Used in the systemic treatment of infections.

Cap: D; Soln for inj: S