Clindamycin dosage, forms, and strengths

Clindamycin is a generic prescription antibiotic used to treat a wide range of bacterial infections of the skin, abdomen, and lungs. People may be most familiar with clindamycin for acne and bacterial vaginosis. Clindamycin comes in many formulations, including topical lotions, gels, foams, oral capsules, oral solutions, and injections. It’s also sold under many brands, including Cleocin, Clindacin, Clindagel, and Clindesse. Clindamycin works by shutting down protein synthesis in bacteria. Since clindamycin has many uses, dosages can vary widely depending on the infection. 

Clindamycin forms and strengths

Because healthcare professionals prescribe clindamycin for various bacterial infections, clindamycin is available in several dosage forms. It also comes in three chemical formulations: clindamycin hydrochloride, clindamycin palmitate, and clindamycin phosphate.

• Capsules: 75 milligrams (mg), 150 mg, 300 mg

• Oral solution: 75 mg/5 mL

• Topical solution: 1% (10 mg/g of solution)

• Aerosol foam: 1% (10 mg/g)

• Gel: 1% (10 mg/g)

• Lotion: 1% (10 mg/g)

• Vaginal cream: 2% (20 mg/g)

• Intramuscular injection: 150 mg/mL

• Intravenous injection: 6 mg/mL, 12 mg/mL, 18 mg/mL

• Vaginal suppositories: 100 mg

Clindamycin dosage for adults

Clindamycin is used to treat bacterial infections. Topical clindamycin is most familiar to people as a treatment for acne or bacterial vaginosis. Oral clindamycin treats serious infections caused by certain anaerobic bacteria, streptococci, and staphylococci. It’s used for severe respiratory infections (including pneumonia), skin infections (cellulitis or infections caused by drug-resistant staphylococcus), soft tissue infections, abdominal infections, pelvic infections in women, endometriosis, and septicemia. It’s also an option to treat strep throat in people allergic to penicillins.

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Clindamycin dosage for acne

People with acne will apply topical clindamycin twice daily. They will also apply benzoyl peroxide separately or by using a product combining benzoyl peroxide and clindamycin. The standard treatment duration is six to eight weeks, but a healthcare provider can continue treatment for longer. However, if there is no improvement after six to eight weeks of treatment, the FDA advises healthcare professionals to discontinue treatment. 

Clindamycin dosage for bacterial vaginosis

Topical clindamycin is a first-line treatment for bacterial vaginosis, but oral clindamycin is not commonly used. Clindamycin doses administered with an applicator are taken once daily, preferably at bedtime. Each dose contains about five to six grams of cream containing 100 to 120 mg of clindamycin. The standard duration of treatment is seven days, but clinicians may choose a shorter treatment duration for non-pregnant women.

• Standard adult dosage for non-pregnant women with BV: One applicator-full applied once daily (preferable at bedtime) for three to seven days

• Standard adult dosage for pregnant women with BV: One applicator-full applied once daily (preferable at bedtime) for seven days

Clindamycin dosage for strep throat

Penicillins are the first choice for treating strep throat, but clindamycin is an alternative choice for people with penicillin allergies. For children, dosing is based on weight: 7 mg/kg taken three times per day for 10 days; for adults, dosing is 300 mg taken three times per day for 10 days. 

Clindamycin dosage for serious bacterial infections

Healthcare professionals prescribe capsules or administer intramuscular or intravenous injections for serious bacterial infections. Dosages and treatment duration will vary based on the severity of the infection. 

• Standard adult dosage for serious bacterial infections: 150–300 mg taken as capsules every six hours OR 600–1200 mg injections administered in two to four equal doses each day

• Standard adult dosage for serious bacterial infections: 450–600 mg (capsules) taken every six hours OR 1200–2700 mg injections administered in two to four equal doses each day

Clindamycin dosage for children

Pediatric dosages for oral or injected clindamycin for serious infections are based on weight, though newborns are a special category. A healthcare professional may prescribe a flavored oral solution to get the correct dose and make it easy for children to take. The FDA has approved topical clindamycin for teens 12 years and older using the same dosage as adults for acne. Clindamycin vaginal cream has not been determined to be safe or effective in anyone but adults, but a healthcare provider may prescribe it off-label. For severe infections, healthcare professionals will use oral or injected clindamycin.

• Standard pediatric dosage for serious bacterial infections in children weighing more than 10 kg: 8–16 mg/kg/day (capsules) divided into three or four equal doses OR 8–12 mg/kg/day (oral solution) divided into three or four equal doses OR 20–40 mg/kg/day (injections) divided into three or four equal doses up to a maximum of 600 mg/dose and 1800 mg/day.

• Standard pediatric dosage for severe bacterial infections in children weighing more than 10 kg: 16–20 mg/kg/day (capsules if they can be swallowed) divided into three or four equal doses OR 17–25 mg/kg/day (oral solution) divided into three or four equal doses OR 40 mg/kg/day (injections) divided every six-eight hours in children between the ages of 1 month and 16 years, up to a maximum of 900 mg/dose and 2700 mg/day.

• Standard pediatric injection dosage for serious bacterial infections in children weighing less than 10 kg: 37.5 mg/day (minimum oral solution dose) in three divided doses OR 15–20 mg/kg/day (injections) divided into three or four equal doses in children younger than one-month-old

Clindamycin dosage restrictions

Clindamycin has no dosage restrictions or reductions for people with renal (kidney) or hepatic (liver) impairment. However, clindamycin can poison the kidneys, so people taking oral clindamycin or getting injections may need regular kidney function monitoring. People with severe liver disease will need regular liver function monitoring. 

Clindamycin dosage for pets

Veterinarians routinely use oral clindamycin in cats and dogs to treat infected wounds, abscesses, dental infections, and bone infections (in dogs). The drug can be administered orally, tablet (dogs only), or capsule (dogs only). The most common side effects are nausea and vomiting.

• Standard dog dosage for infected wounds, abscesses, or dental infections: 2.5-15.0 mg/lb every 12 hours for a maximum of 28 days if there’s no improvement

• Standard dog dosage for bone infections (osteomyelitis): 5-15.0 mg/lb every 12 hours for a maximum of 28 days if there’s no improvement

• Standard cat dosage for infected wounds, abscesses, or dental infections: 5-15.0 mg/lb every 24 hours for a maximum of 14 days if there’s no improvement

How to take clindamycin

The doctor will tell you how much medicine to use. Do not use more than directed. Take all the medicine in your prescription to clear up your infection, even if you feel better after the first few doses. Clindamycin is pretty straightforward, but some formats may require extra steps or precautions. This includes: 

Capsule 

• Swallow the capsule whole with a full glass of water.

• Store the medicine in a closed container at room temperature, away from heat. 

Oral liquid

• Measure the liquid medicine with a marked measuring spoon, oral syringe, or medicine cup. If you don’t have one, ask the pharmacist. Do not use kitchen measuring devices.

• Store at room temperature. Do not refrigerate or freeze. Throw away any unused medicine after 14 days.

Topical creams, lotions, or gels

• Wash the skin with soap and water and allow the skin to fully dry.

• Apply a thin film to the affected skin.

• Store at room temperature. Do not freeze.

Topical solution

• Wash the skin with soap and water and allow the skin to fully dry.

• This medicine comes with an applicator that requires you to insert the applicator into the medicine and seal it with a cap when you first get it.

• Use the applicator to dab (not rub) a thin solution film on the affected skin.

• Store the container upright and tightly closed at room temperature. Do not freeze.

Topical foam

• Wash the skin with soap and water and allow the skin to fully dry.

• Make sure the can is cool, or the foam will be runny.

• Spray the foam into the cap or onto a cool surface.

• Do not apply the foam directly to the hands, or it will quickly melt.

• Take a small amount of foam on a fingertip and massage it on affected skin areas.

• Avoid getting any in your eyes or mouth.

• Dispose of any unused foam.

• The foam may be flammable, so avoid smoking, fire, or flames after applying the medicine to the skin.

• Store at room temperature. Because the contents are under pressure, do not expose the container to temperatures over 120˚.

• Do not puncture the container.

Vaginal cream

• Doses are administered with disposable applicators.

• Insert an applicator into the end of the tube.

• Roll the tube from the bottom until the applicator’s plunger is fully extended.

• Doses should be applied when lying on your back.

• Ensure the applicator is inserted as far inside the vagina as it can comfortably reach.

• Administer the entire amount slowly until the plunger is fully down.

• Exercise care when inserting and removing the applicator.

• Throw away the applicator.

• Store at room temperature. Do not freeze.

Clindamycin dosage FAQs

How long does it take clindamycin to work?

For severe infections, clindamycin may take several days to start improving symptoms. For bacterial vaginosis, symptoms should improve in a couple of days. However, take the medication for the entire prescribed duration to eliminate all the bacteria. For, it may take several weeks for clindamycin to show improvements. 

What happens if I miss a dose of clindamycin?

Take a missed dose as soon as it’s remembered, except when it’s almost time for the next dose. In that case, take the next dose as scheduled without doubling the dose or adding extra medicine.

Is it safe to take clindamycin during pregnancy?

Clindamycin is prescribed to pregnant women. There is no evidence that using clindamycin will cause birth defects or other problems during pregnancy. Clindamycin is also prescribed to women who are breastfeeding. Again, there is no evidence that the use of clindamycin affects lactation or the nursing baby.

What are the risks of taking clindamycin?

Clindamycin can cause adverse effects such as rash, nausea, diarrhea, and abdominal pain. Drug interactions can also cause problems. The most serious side effects include kidney damage, severe hypersensitivity, and severe skin reactions. The drug is contraindicated in anyone who has had an allergic reaction to clindamycin or lincomycin, a related drug. 

However, the most serious adverse effect of clindamycin is an overgrowth of Clostridium difficile in the colon, causing C. difficile-associated diarrhea (CDAD), a severe form of diarrhea. At its worst, C. difficile overgrowth can cause a life-threatening gastrointestinal disease called pseudomembranous colitis or C. difficile colitis. This can happen within a few days after clindamycin is taken. For this reason, clindamycin should be avoided in people with ulcerative colitis. 

Serious side effects are less likely when using topical clindamycin.

Related resources for clindamycin dosages:

• Clindamycin, StatPearls

• Clindamycin HCl capsule prescribing information, National Library of Medicine

• Clindamycin palmitate hydrochloride granules prescribing information, National Library of Medicine

• Clindamycin phosphate aerosol foam prescribing information, National Library of Medicine

• Clindamycin phosphate injection prescribing information, National Library of Medicine