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Clindamycin is a lincosamide antibiotic used in children for skin and soft-tissue infections, including MRSA coverage in some regions, and as an alternative for penicillin-allergic patients. Typical pediatric dosing is 20–40 mg/kg/day divided every 6–8 hours.
Weight‑based dosing: 20–40 mg/kg/day divided q6–8h
Common oral suspension concentration: 75 mg/5 mL (palmitate)
Counsel families to watch for significant diarrhea—risk of C. difficile
Consider local susceptibility patterns for MRSA and streptococci
Use total daily cap in outpatient settings to reduce toxicity risk
Clindamycin is commonly used for pediatric skin and soft‑tissue infections when MRSA coverage is desired or in penicillin‑allergic patients.
Select clindamycin when local resistance patterns support its use. Culture‑directed therapy is preferred whenever possible.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| Skin and soft-tissue infections (cellulitis, abscess) | Children and adolescents | No | Common alternative when MRSA coverage desired and local susceptibility supports use; also for penicillin allergy. |
| Osteoarticular infections (adjunct or step-down per specialist) | Children and adolescents | No | Use under specialist guidance and culture results. |
| Recurrent tonsillitis or dental infections (selected cases) | Children and adolescents | No | Alternative in penicillin allergy where coverage is appropriate |
FDA-approved primary uses with Level A evidence
Quick selection guides and diagnostic pearls
When to consider other medications
How to explain treatment to families
Clindamycin is commonly used in children and is usually well tolerated. Mild stomach upset or loose stools can happen and are typically temporary. More serious diarrhea is uncommon, but it’s important to know when to call so we can support you quickly.
Most common effects are gastrointestinal (diarrhea, nausea, abdominal pain). Serious diarrhea or blood/mucus in stools suggests possible C. difficile infection—seek medical care.
Diarrhea (including antibiotic‑associated colitis)
Common; serious cases uncommon • Variable; potentially serious
Nausea, vomiting, abdominal pain
Common • Usually mild
Rash, pruritus
Uncommon • Usually mild
Elevated transaminases
Uncommon • Usually transient
Organized by affected organ systems
How to discuss side effects with families
Management protocols and monitoring
Common concerns and practical guidance
Practical guidance for safe pediatric clindamycin use.
Shake the suspension well each time. Measure the dose with an oral syringe (not a kitchen spoon) and give it slowly into the cheek. It’s common for kids to have a bit of stomach upset—giving the dose with a small snack or milk can help, and that’s expected.
Gentle reminders for peace of mind: space doses every 6–8 hours, keep a simple dosing log so you don’t have to remember under pressure, and offer sips of fluids after the dose. If diarrhea becomes severe or persistent, it’s okay to pause and call—your care team is here for you.
Emergency contact: Contact your clinician for bloody diarrhea, severe abdominal pain, or signs of dehydration.
Consistent spacing and careful monitoring for GI symptoms improve safety.
Different formulations and concentrations
Safe preparation and measuring techniques
Tailored approaches for different ages
Solutions for common challenges
Storage guidelines and safety tips
Expert pearls and evidence-based tips
Protein synthesis inhibition at the 50S ribosome reduces bacterial toxin production and growth.
Clindamycin binds the 50S ribosomal subunit and inhibits protein synthesis, overlapping the macrolide binding site. It retains activity against many Gram‑positive organisms and anaerobes.
Simple explanations and helpful analogies
Receptors, enzymes, and cellular targets
Absorption, metabolism, and elimination
Age-related differences and special populations
Clinical pearls to improve outcomes and reduce harm when using clindamycin in children.
Focus on GI safety, dose spacing, and culture‑directed therapy.
Call if blood or mucus in stool
Severe or bloody diarrhea requires prompt evaluation; stop medication and seek care.
Every 6–8 hours as prescribed
q6–8h spacing improves pharmacodynamic coverage and tolerability.
Cultures help pick the right antibiotic
Adjust therapy once susceptibilities return; consider local MRSA/strep patterns.
Core insights every provider should know
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Recent updates that change how we practice
Organized by dosing, administration, and safety
How to explain treatments to families
Real-world cases with evidence-based approaches
Key numbers, algorithms, and decision tools
Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Clindamycin and monitor your child's response to treatment.
Every 6–8 hours, divided into 3–4 doses per day as prescribed.
Yes. A small snack may reduce stomach upset.
Mild diarrhea is common. For severe, persistent, or bloody diarrhea, stop and seek medical advice immediately.
Clindamycin is not a penicillin and is often used as an alternative. Confirm with your clinician.