Lincosamides

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Lincosamides
General Information   

•Penicillin substitute

•Effectiveness is similar to penicillin but differs in structure

•Active against gram positive bacteria

•Not active against gram negative bacteria

Uses/Indications

To treat bacterial infections of the:

•Lungs

•Skin

•Blood

•Female reproductive organs

•Internal organs

Mechanism of Action

•Binds to 50S subunit of bacterial ribosomes, suppresses protein synthesis

•Primarily bacteriostatic

•May be bacteriocidal

Examples

clindamycin Hcl (Cleocin),

clindamycin palmitate (Cleocin Pediatric)

clindamycin phosphate (Cleocin Phosphate)

•Adult PO: 150-450 mg q6-8 h (max: 2700mg/d)

•Child PO: 8-20mg/kg/d in 3-4 divided doses (max: 20 mg/kg/d)

•Adult IM/IV: 600-1200 mg/d in divided doses (max: 4800 mg/d)

•Child IM/IV: 20-40 mg/kg/d in 3-4 divided doses (max: 40 mg/k/d)

•Available in capsule form

•Take with full glass of water

•Not affected by food

•May cause fatal colitis

•Pregnancy category: B

•Highly Protein Bound: 94%

•Half life: 2-3 h

Examples continued...

       Lincomycin (Lincocin)

•Adult IM: 600 mg q12-24h

•Adult IV: 600 mg to 1 g q8-12h (max: 8 g/d)

•Child IM: 10 mg/kg q12-24h

•Child IV: 10-20 mg/kg/d q8-12h

•Replaced by Clindamycin in most cases

•May cause fatal colitis

•Dilute in 100 mL fluids if given IV

•Pregnancy category: B

•Moderately protein bound: 70%

•Half life: 4-6 h

Side Effects and Adverse Reactions

•Side effects:

•GI irritation, nausea, vomiting, stomatitis

•Rash

•Severe adverse reactions:

•Colitis

•Anaphylactic shock

•C. difficile

•Steven-Johnson Syndrome

Drug Interactions

Incompatible with:

•Aminophylline

•Phenytoin (Dilantin)

•Barbiturates

•Ampicillin

Unlabeled Uses

•Acne rosacea

•Bacillus anthracis

•Dental infections

•Folliculitis

•Malaria

•Pemphigus

•Periodontitis

•Toxoplasmosis

Nursing Considerations/Patient Education

•Monitor bowel patterns

•Monitor AST/ALT

•C&S pre-therapy

•Complete full prescription as prescribed

•Monitor for skin reactions

•Take with food and water

Interesting information

The American Academy of Allergy, Asthma & Immunology presented a recent clinical trial in 2013. The following was found during this study:

• 500 participants only 1.8% were found to have true allergy

• PCN allergy raises use in Clindamycin

• Increases C.Difficile infections