Lincomycin derivatives

Lincomycin derivatives

Because of its high potential for causing serious adverse effects, clindamycin is an-other antibacterial prescribed only when there’s no therapeutic alternative. It’s used for many gram-pos-itive and anaerobic organisms.

Less from lincomycin

Lincomycin is less effective than clindamycin andis rarely used. Lincomycin shouldn’t be used in the treatment of minor infections but would be used to treat serious respiratory or skin infections in the patient who’s al-lergic to other antibiotics indicated for the infection.

Pharmacokinetics

When taken orally, clindamycin is absorbed well and distributed widely throughout the body. It’s metabolized by the liver and ex-creted by the kidneys and biliary pathways. About 20% to 30% of lincomycin, when taken orally, is absorbed from the GI tract; food delays its absorption. Lincomycin is partially metabolized in the liver and is excreted in the urine, stool, and bile.

Pharmacodynamics

Clindamycin and lincomycin inhibit bacterial protein synthesis by inhibiting the binding of bacterial ribosomes. At therapeutic con-centrations, clindamycin is primarily bacteriostatic against most organisms.

Pharmacotherapeutics

Because of their potential for causing serious toxicity and pseudomembranous colitis (characterized by severe diarrhea, ab-dominal pain, fever, and mucus and blood in stool), these drugs are limited to a few clinical situations in which safer alternative antibacterials aren’t available.

§    Clindamycin is potent against most aerobic gram-positive organ-isms, including staphylococci, streptococci (except Enterococcusfaecalis), and pneumococci.

§    Clindamycin is effective against most clinically important anaer-obes and is used primarily to treat anaerobic intraabdominal, pleural, or pulmonary infections caused by Bacteroides fragilis. It’s also used as an alternative to penicillin in treating Clostridiumperfringens infections.

§    Clindamycin and lincomycin may be used as alternatives to penicillin in treating staphylococcal infections in a patient who’s allergic to penicillin

Drug interaction

Clindamycin and lincomycin have neuromuscular blocking prop-erties and may enhance the neuromuscular blocking action of neuromuscular blockers. This can lead to profound respiratory de-pression. (See Adverse reactions to clindamycin.)