Clindamycin

In the event of penicillin allergy, clindamycin is an alternative choice in treating mild or early odontogenic infection. Clindamycin, because of its broad spectrum of activity and resistance to beta-lactamase degradation is an excellent substitute for penicillin resistant bacteria. It is highly effective against almost all oral pathogens. It is not effective against mycoplasma or gram-negative aerobes. Administration with food does not significantly impair absorption. Adverse effects of clindamycin include abdominal pain, nausea, vomiting, and diarrhea.

Contraindications: Hypersensitivity to clindamycin or any component of the formulation; previous pseudomembranous colitis, regional enteritis, ulcerative colitis.

Warnings/Precautions: Use with caution in patients with liver dysfunction (modify dosage); can cause severe and fatal colitis; discontinue drug if significant diarrhea, abdominal cramps or blood and mucus passage occurs.

The usual daily oral dose for treating odontogenic infections in children is:

Children under 12 years: 10-25 mg/kg/day in 3 equally divided doses for 10 days.
Children over 12 years and adults 600-1800 mg/day in 3 divided doses for 10 days. The maximum dose is 2-3 gms/day.
Clindamycin is supplied as a 75 mg/5 ml solution or 150, 300, 450, 600, 750, 900 mg tablets.

Sample clindamycin prescription for a 3-year-old patient weighing 12 kg (25 lb) with facial swelling:

Rx: Clindamycin 75 mg/5 ml
Disp: 150 ml
Sig: Take 1 teaspoon every 8 hours for 10 days