Clindamycin, pediatric dosing

For penicillin-allergic patients, use clindamycin 150-300 mg orally every 6-8 hours (pediatric dosing 10-30 mg/kg/day in three to four divided doses). 

In P. falciparum (chloroquine-resistant) infections, a dose of 750 mg mefloquine followed by 500 mg 12 hours later is recommended. The pediatric dose of mefloquine is 15 mg/kg (<45 kg) followed by 10 mg/kg 8 to 12 hours later.Intravenous quinidine gluconate followed by oral quinine should be administered for severe illness, as already indicated.A second drug needs to be administered in chloroquine-resistant P. falciparum, and this second drug should follow the oral quinidine regimen either a single dose of three tablets of pyrimethamine-sulfadoxine (Fansidar) on the last day of intravenous quinidine or clindamycin 900 mg three times daily for 3 to 5 days. An alternative oral treatment for chloroquine-resistant P falciparum infection in adults, especially in those with a history of seizures or psychiatric disorders, is the combination of atovaquone 250 mg and proguanil 100 mg (Malarone) (4 tablets daily... 

Clindamycin. The adult or pediatric dosage is 20 mg (base)/kg/day, oraUy, divided into 3-4 doses, for 7 days. 

THERAPEUTIC USES The oral dose of chndamycin (cleocin) for adults is 150-300 mg every 6 hours for severe infections, it is 300-600 mg every 6 hours. Children should receive 8-12 mg/kg/day of clindamycin palmitate hydrochloride (cleocin pediatric) in three or four divided doses, or for severe infections, 13-25 mg/kg/day. However, children weighing <10 kg should receive half teaspoonful of this preparation (37.5 mg) every 8 hours as a minimal dose. 

Trimethoprim-sulfamethoxazole (TMP-SMX) (20 mg/kg/day of trimethoprim) is the treatment of choice for P. carinii pneumonia (PCP). Oral therapy with TMP-SMX is reserved for children with mild PCP who do not have malabsorption or diarrhea. Intravenous pentamidine (4 mg/kg/day, given once a day) can be given to children with PCP who are intolerant of TMP-SMX or who have not responded after 5 days of TMP-SMX therapy. Other treatment regimens that may be considered for patients who are intolerant of or fail TMP-SMX and pentimidine are (1) atovaquone (40 mg/kg/ day, in two divided doses) for mild/moderate PCP only (2) dapsone with trimethoprim (3) trimetrexate with leucovorin and (4) clindamycin and primaquine. These alternate treatments have limited experience in pediatric patients. 

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