In the presence of strong CYP3A4 inhibitors, monitor for adverse reactions. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin palmitate hydrochloride for oral solution (Pediatric) and other antibacterial drugs, clindamycin palmitate hydrochloride for oral solution (Pediatric) should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria. Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2,618 mg/kg. Therefore, dosage modification in patients with liver disease may not be necessary. About 90% of an oral dose of clindamycin is absorbed after oral administration. In the presence of strong CYP3A4 inhibitors, monitor for adverse reactions. Because clindamycin therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate, as described in the Clindamycin palmitate hydrochloride USP is a water soluble hydrochloride salt of the ester of clindamycin and palmitic acid. Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Prescribing clindamycin palmitate hydrochloride for oral solution in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug- resistant bacteria.Patients should be counseled that antibacterial drugs including clindamycin palmitate hydrochloride for oral solution should only be used to treat bacterial infections. Take this medication by mouth with or without food, usually 4 times a day (every 6 hours), or as directed by your doctor. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum. Clindamycin palmitate hydrochloride for oral solution is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. However, it was postulated from studies that when given every eight hours, accumulation should rarely occur. Because the binding sites for these antibacterial drugs overlap, cross-resistance is sometimes observed among lincosamides, macrolides and streptogramin B. Macrolide- inducible resistance to clindamycin occurs in some isolates of macrolide-resistant bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci and staphylococci. By the fifth dose, the 6-hour serum concentration had reached equilibrium. Serum half-life of clindamycin is increased slightly in patients with markedly reduced renal function. However, it was postulated from studies that when given every eight hours, accumulation should rarely occur. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.If significant diarrhea occurs during therapy, this antibiotic should be discontinued (see Concomitant administration of food does not adversely affect the absorption of clindamycin palmitate HCl contained in clindamycin palmitate hydrochloride for oral solution (Pediatric) flavored granules.Serious infections: 8-12 mg/kg/day (4-6 mg/lb/day) divided into 3 or 4 equal doses.Severe infections: 13-16 mg/kg/day (6.5-8 mg/lb/day) divided into 3 or 4 equal doses.More severe infections: 17-25 mg/kg/day (8.5-12.5 mg/lb/day) divided into 3 or 4 equal doses.In pediatric patients weighing 10 kg or less, ½ teaspoon (37.5 mg) three times a day should be considered the minimum recommended dose.Serious infections due to anaerobic bacteria are usually treated with clindamycin injection. In the mice, convulsions and depression were observed. Clindamycin palmitate HCl for oral solution, USP (pediatric) is a white to off-white powder forming a clear colorless cherry flavored solution upon constitution with water. Clindamycin is a semisynthetic antibiotic produced by a 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound lincomycin. Inactive ingredients: natural cherry flavor, dextrin, ethylparaben, poloxamer 188, simethicone, sucrose.Blood level studies comparing clindamycin palmitate HCl with clindamycin hydrochloride show that both drugs reach their peak active serum levels at the same time, indicating a rapid hydrolysis of the palmitate to the clindamycin.Serum level studies with clindamycin palmitate HCl in normal pediatric patients weighing 50-100 lbs given 2, 3 or 4 mg/kg every 6 hours (8, 12 or 16 mg/kg/day) demonstrated mean peak clindamycin serum levels of 1.24, 2.25 and 2.44 mcg/mL respectively, one hour after the first dose. Severe infections: 13 to 16 mg/kg/day (6.5 to 8 mg/lb/day) divided into 3 or 4 equal doses. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by clindamycin palmitate hydrochloride for oral solution (Pediatric) or other antibacterial drugs in the future.Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued.