lincomycin

Action and Spectrum

Actions and Spectrum: 

lincomycin has a broad spectrum of activity against Gram-positive and some anaerobic bacteria. It is active against Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, and anaerobic bacteria such as Bacteroides fragilis, Clostridium perfringens, and Peptostreptococcus species. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Vomiting 

Abdominal pain 

Glossitis 

Pruritus 

Angioedema 

Nausea 

Diarrhea 

Tenesmus 

Stomatitis 

Urticaria 

Exfoliative/vesiculobullous dermatitis 

Thrombophlebitis 

Pain 

Rash 

Vaginitis 

Erythema multiforme 

Erythema 

Swelling 

Agranulocytosis 

Myalgia 

Dizziness 

Thrombocytopenia 

Headache 

Tinnitus 

Vertigo 

Post marketing reports 

Anal pruritus 

Clostridium difficile colitis 

Aplastic anemia 

Liver function test abnormal 

Renal impairment 

Azotemia 

Cardio-respiratory arrest 

Pseudomembranous colitis 

Pancytopenia 

Thrombocytopenic purpura 

Transaminases increased 

Proteinuria 

Black Box Warning

Black box warning: 

lincomycin has a black box warning, the strictest warning issued by the U.S. Food and Drug Administration (FDA). The black box warning for lincomycin states that the medication can cause severe colitis and potentially fatal diarrhea. This colitis may occur during or after treatment and can range from mild to life-threatening.

It is essential to discontinue the medication if the patient develops severe diarrhea during or after treatment. The black box warning also cautions against using lincomycin in patients with a history of gastrointestinal disease or disorders, as they may be at increased risk of developing colitis. It is recommended to use lincomycin only to treat serious bacterial infections when other, less toxic alternatives are unavailable. 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

lincomycin is an antibiotic medication used to treat various bacterial infections. However, it is essential to note that there are specific contraindications or situations where lincomycin should not be used. These include: 

• Hypersensitivity or allergy to lincomycin or any of its components. 
• A history of antibiotic-associated colitis or Clostridium difficile-associated diarrhea. 
• Liver or kidney disease. 
• Severe asthma or other respiratory disorders. 
• Pregnancy or breastfeeding. 
• Use of certain medications, such as neuromuscular blocking agents. 

Caution: 

• Use with caution in patients with a history of gastrointestinal disease or disorders. 
• Use caution in patients with a history of allergic reactions to other antibiotics. 
• Use with caution in patients with a history of liver or kidney disease. 
• Use caution in elderly patients, as they may be more susceptible to specific side effects of the medication. 
• Use caution in patients with a history of seizures or other neurological disorders. 
• Use with caution in patients with a history of myasthenia gravis. 
• Use caution in patients with a history of asthma or other respiratory disorders. 

Pregnancy / Lactation

Pregnancy consideration: Insufficient data available 

Lactation: Excretion of the drug in human breast milk is known 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

lincomycin is an antibiotic that belongs to the lincosamide class of antibiotics. It is a broad-spectrum antibiotic primarily used to treat infections caused by anaerobic bacteria, such as Streptococcus, Staphylococcus, and Mycoplasma. 

lincomycin works by inhibiting bacterial protein synthesis, specifically by binding to the 50S ribosomal subunit of the bacterial ribosome, which prevents the elongation of peptide chains during protein synthesis. This leads to the inhibition of bacterial growth and ultimately causes bacterial death. 

Pharmacodynamics: 

The pharmacodynamics of lincomycin involves its interaction with bacterial ribosomes and inhibition of protein synthesis, ultimately leading to the bacteriostatic or bactericidal effect on susceptible organisms.  

lincomycin binds to the 50S ribosomal subunit of bacterial ribosomes and prevents the addition of amino acids to the growing polypeptide chain during protein synthesis. This results in the inhibition of bacterial growth and replication. 

lincomycin has a broad spectrum of activity against many Gram-positive and Gram-negative bacteria and anaerobic bacteria such as Bacteroides fragilis. It is particularly effective against Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus.  

The bacteriostatic or bactericidal effect of lincomycin depends on the concentration of the drug, the type of bacteria, and the site of infection. At lower concentrations, lincomycin has a bacteriostatic effect, inhibiting bacterial growth but not killing the bacteria. It can have a bactericidal effect at higher concentrations, meaning it directly kills the bacteria. 

Pharmacokinetics: 

Absorption 

lincomycin can be administered orally, intravenously, or intramuscularly. Oral absorption of lincomycin is relatively low, with only 30-40% of the drug being absorbed. After oral administration, the drug is rapidly absorbed from the gastrointestinal tract and reaches peak plasma concentrations within 1-2 hours. Intravenous or intramuscular administration results in a more rapid onset of action, with peak plasma concentrations achieved within 30-60 minutes.  

Distribution 

lincomycin has a relatively low volume of distribution, indicating that it is mainly confined to the bloodstream and extracellular fluid. The drug can cross the blood-brain barrier, but its concentration in cerebrospinal fluid is relatively low. lincomycin is also known to accumulate in bone and can effectively treat bone infections.  

Metabolism 

lincomycin undergoes hepatic metabolism via glucuronidation and N-demethylation. The primary metabolite of lincomycin is N-desmethyl-lincomycin, which is less active than the parent drug. The metabolism of lincomycin is relatively slow, and the elimination half-life is approximately 5 hours.  

Elimination and Excretion 

lincomycin and its metabolites are primarily eliminated in the bile and excreted in feces. A small amount of the drug is also excreted in the urine. lincomycin is not significantly removed by haemodialysis or peritoneal dialysis. 

Adminstartion

Administration: 

• lincomycin can be administered by different routes, including oral, intravenous, and intramuscular routes. The specific route of administration depends on the indication for use, the severity of the infection, and the patient’s clinical condition. 
• Oral lincomycin is available in capsules or tablets and should be taken on an empty stomach with a full glass of water to improve absorption. The recommended dose for adults is usually 500 mg to 1000 mg every 6 to 8 hours, depending on the severity of the infection. Pediatric doses are based on body weight and are typically given every 6 to 8 hours. 
• Intravenous lincomycin is usually reserved for severe infections or when oral administration is impossible. The drug is usually given slowly for 10 to 15 minutes, and the dose depends on the patient’s weight, age, and severity of the infection. 
• Intramuscular lincomycin is also an option and can be used when intravenous access is unavailable. The drug is usually given deep into the muscle, and the dose depends on the patient’s weight, age, and severity of the infection. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: lincomycin 

Why do we use lincomycin? 

lincomycin is an antibiotic medication that is used to treat various types of bacterial infections, including: 

• Respiratory tract infections: lincomycin is effective against Streptococcus pneumoniae, Streptococcus pyogenes, and other bacteria that cause pneumonia, bronchitis, and other respiratory tract infections 
• Skin and soft tissue infections: lincomycin can treat skin and soft tissue infections caused by bacteria such as Staphylococcus aureus, Streptococcus pyogenes, and other anaerobic bacteria. 
• Bone and joint infections: lincomycin can treat bone and joint infections caused by susceptible bacteria. 
• Intra-abdominal infections: lincomycin can be used to treat infections of the abdominal cavity, such as peritonitis, caused by susceptible bacteria. 
• Pelvic infections: lincomycin can be used to treat infections of the female reproductive system, such as endometritis and pelvic inflammatory disease.