Infections caused by anaerobes, Streptococci, Staphylococci or pneumococci.

Clindamycin inhibits bacterial protein synthesis at the bacterial ribosomal level. It binds with preference to the 50S ribosomal subunit and affects the peptide chain initiation process

Absorption
1. Oral bioavailability：約 90%
2. Clindamycin palmitate 為前驅藥，需於腸胃道水解後具活性
3. Peak concentration：口服約 1 小時；IM 約 1–3 小時

Distribution
1. 廣泛分布於體液及組織
2. CSF 濃度低（即使腦膜發炎）
3. Protein binding：約 94%
4. Volume of distribution (Vd)：
• Neonates：約 1–1.3 L/kg
• Infants/Children：約 0.8–1 L/kg
• Adolescents/Adults：約 ~0.8–1 L/kg

Metabolism
1. IV 製劑（clindamycin phosphate）快速轉換為活性 clindamycin
2. 主要經 CYP3A4 代謝（次要 CYP3A5）

Elimination
Half-life：
• Neonates：約 4–6 hours
• Infants/Children：約 2–3 hours
• Adults：約 3 hours
• Elderly：約 4 hours

Excretion：
Urine：約 10%
Feces：約 3–4%

Hypersensitivity, diarrhea states.

B

Probably safe; it has the possible to depress bowel normal flora, to interfere culture interpretation, or to induce allergy reaction in infant.

Diarrhea, Pseudomembranous colitis, hypersensitivity reactions, agranulocytosis, thrombocytopenia.

Adults: 0.6-2.7 g/day in divided doses IM or slow IV. 
Children: 15-40 mg/kg/day in divided doses IM or slow IV, maximum dose: 2.7-4.8 g/day

Infants, Children, and Adolescents:
IM, IV: 20 to 40 mg/kg/day divided every 6 to 8 hours; maximum daily dose: 2,700 mg/day.

Oral: 10 to 25 mg/kg/day divided every 8 hours; higher doses of 30 to 40 mg/kg/day divided every 6 to 8 hours recommended for some infections, see specific indication; maximum daily dose: 1,800 mg/day.

No dosage adjustment necessary.

No dosage adjustment necessary.

安定性：室溫：16 days；冷藏(2-8℃)：32 days