The effect of impairment of renal function and dialysis on the serum and urine levels of clindamycin.

A single 150 mg oral dose of clindamycin was given to three healthy volunteers and 13 patients with varying degrees of renal functional impairment. The mean peak serum levels in the two groups were 2.55 +/- 0.92 mug/ml and 3.39 +/- 0.68 mug/ml respectively. In all patients the levels greatly exceeded the minimum inhibitory concentration for sensitive pathogens. The serum half-life was extremely variable in patients with renal failure and bore no relationship to the glomerular filtration rate. In the normal subjects 11.9% of the administered dose was excreted in the urine but in severe renal failure less than 1% of the bioactivity was detected in the urine in 24 hours. The drug was not removed by haemodialysis. In patients with mild to moderate impairment of renal function no dosage adjustment of clindamycin is necessary. However, in those with severe renal failure some modification to dosage would be prudent and this should be monitored by measuring serum levels of the antibiotic.