Lincosamides

By: Kriste Frasier RN

Overview

• Similar to effects of penicillins
• Penicillin substitute in patients who have an allergy

Mechanism of Action
Inhibits bacteria protein synthesis, causing cell death through bacteriostatic action. In higher doses can have bactericidal action.

Indication for use

• Strep and Staph infections
• Acne vulgaris
• BV

Other uses
Combination therapy for cerebral toxoplasmosis, toxigenic strep, and pneumocystis jirovecii

Examples
Clindamycin (Cleocin)
lincomycin (Lincocin)
 *Incompatible with certain drugs such as phenytoin, aminophylline, cefazolin/gent, ceftriaxone, ranitidine, and calcium gluconate.

Routes of administration
PO, IV, topically, and Intravaginally

Side effects
hypotension, abdominal pain, n/v, neutropenia, rashes, fatigue, headache, cardiac arrest (with rapid IV administration), pseudomembranous colitis (potentially fatal)

Contraindications
Prior history of allergic reaction to medication
Hx of asthma or any other respiratory
Hx of renal or hepatic dysfunction
Patients taking MAOI, SSRI, or tricyclic antidepressants
Hx of hematologic reactions
Pregnancy/breastfeeding

Dosing Considerations
Consider adjusting dosages for patients with renal and liver dysfunction
In pregnant patients, lincosamides can pass through the placenta and cumulate in the fetus' liver

Drug interactions
Digoxin
Warfarin
Estrogens

Nursing Interventions
Obtain health history including allergies and allergic reactions
Baseline blood work including renal and liver function
Vital signs
Assessment of wounds for infections - obtain C&S, rashes, lesions
Assess lung and bowel sounds

Client Teaching
Take oral antibiotic with a full glass of water
Take entire course of antibiotic treatment as prescribed
Report to health care provider if no change symptoms of infection
Report any symptoms such as persistent diarrhea, abdominal pain, or n/v
Topical solution - avoid contact with eyes and mucous membranes - flush with copious amount of cool water
Refrain from sexual intercourse during treatment for BV


References

Kee, J. L., Hayes, E. R., & McCuistion, L. E. (2012). Macrolides, Tetracyclines, Aminoglycosides, and Fluoroquinolones. In Pharmacology: A nursing process approach (p. 428). St. Louis, MO: Elsevier Saunders.

Levison, M. E. (2009, July). Lincosamides, Oxazolidinones, and Streptogramins: Bacteria and Antibacterial Drugs: Merck Manual Professional. Retrieved March 2, 2014, from http://www.merckmanuals.com/professional/infectious_diseases/bacteria_and_antibacterial_drugs/lincosamides_oxazolidinones_and_streptogramins.html

Lincosamides - comprehensive review on Antibioticslist.com. (n.d.). Retrieved March 2, 2014, from http://www.antibioticslist.com/lincosamides.html