2) Is the Clindamycin dosage prescribed for “Patient 3” in the article acceptabl

Question

2)   Is the Clindamycin dosage prescribed for “Patient 3” in the article acceptable? Why or why not?

Frederick Ames is a 25-year-old man with a penicillin allergy who has been admitted with a serious staphylococcal bone infection. He is treated with clindamycin by intravenous infusion (EMC, 2014c). According to the BNF, the dose of clindamycin is 0.6–2.7 g daily in two to four divided doses. e medical team has prescribed 600 mg four times a day. Is this dose acceptable?

Your colleague has found the product supplied by the pharmacy, which is clindamycin 150 mg/ml injection in
4 ml ampoules, and plans to draw up the contents of 4 ampoules in order to give the prescribed dose. Is this correct?

Finally, you need to check the dilution. Appendix 4 of the BNF says clindamycin should be diluted to a solution containing not more than
18 mg/ml with normal saline or glucose 5%. It must be administered at a rate not exceeding 30 mg/minute. Your colleague intends to add the dose to 250 ml normal saline and to set the IV pump to give the infusion over 15 minutes. Is this correct?

Explanation / Answer

The dosages described for Frederick is not acceptable. The dosages seem to be high and incorrect.

Clindamycin dosages are described below which are acceptable dosages:

Relates to the subsequent strength(s):

-Dosages 150 mg/mL; 150 mg; 75 mg; 300 mg;

-Dosages 75 mg/5 mL ; 600 mg-5%/50 mL ; 300 mg-5%/50 mL ; 900 mg-5%/50 mL ;

-Dosages 300 mg/50 mL-NaCl 0.9%; 600 mg/50 mL-NaCl 0.9%; 900 mg/50 mL-NaCl 0.9%; phosphate; hydrochloride

In case of bacterial infection in case of adult patient:

Oral administration:

Severe infection: 150 to 300 mg orally each 6 hours

Added severe infection: 300 to 450 mg orally each 6 hours

Parenteral administration:

Serous contamination: 600 to 1,200 mg via IV infusion or IM inoculation per day, in 2 to 4 similarly separated doses

Severe infection: 1,200 to 2,700 mg via IV infusion or IM inoculation per day, in 2 to 4 similarly divided doses

Added severe infection: Up to 4,800 mg by IV infusion per day

Explanation:

-Solitary IM injection larger than 600 mg is not suggested

-Solitary 1 hour IV infusion larger than 1,200 mg is not suggested

-For management of anaerobic contaminations, parenteral clindamycin must be used originally and then patients altered to oral treatment when clinically suitable.

-Clindamycin should be set aside for penicillin sensitive patients or other patients for whom a penicillin is not suitable.

-Combination treatment with extra antibiotics may be obligatory rendering to normal action procedures. Action should be directed by ethos and vulnerability trainings.

How to use:

Considerate contaminations shaped by susceptible bacteria or other organisms:

-Staphylococci, streptococci, and pneumococci, including serious respiratory region contaminations and skin and soft tissue contaminations

-Anaerobes, counting serious respiratory territory infections, considerate skin and soft flesh contagions, septicemia, intra-abdominal contaminations, and contaminations of the female pelvis and genital zone.

-Bone and joint contagions counting acute hematogenous osteomyelitis produced by Staphylococcus aureus also as adjunctive treatment in the surgical action of chronic bone and joint contagions

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