Lincomycin
Pronunciation: (LIN-koe-MYE-sin)Class: Antibiotic
Trade Names:
Lincocin
- Injection 300 mg/mL
Pharmacology
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Suppresses bacterial protein synthesis.
Pharmacokinetics
Absorption
Following IM administration, average C max is 11.6 mcg/mL at 60 min and therapeutic levels are maintained for 17 to 20 h for most susceptible gram-positive organisms. Following a 2-hour IV infusion, average C max is approximately 16 mcg/mL and therapeutic levels are maintained for 14 h for most susceptible gram-positive organisms.
Elimination
Urinary excretion following IM and IV administration ranges from 1.8% to 24.8% and 4.9% to 30.3%, respectively. The t ½ is 5.4 h. Biliary excretion is an important route of elimination.
Special Populations
Renal Function ImpairmentSerum t ½ may be prolonged in patients with severe renal function impairment.
Hepatic Function ImpairmentSerum t ½ may be 2-fold longer in patients with abnormal hepatic function.
Indications and Usage
Treatment of serious infections caused by susceptible strains of streptococci, pneumococci, and staphylococci. Reserve use for patients in whom penicillin is inappropriate.
Contraindications
Hypersensitivity to lincomycin or clindamycin.
Dosage and Administration
AdultsIV For serious infections, administer 600 to 1,000 mg every 8 to 12 h. For more severe infections, the dose may be increased. In life-threatening infections, doses up to 8 g/day have been given (max, 8 g/day).
Children older than 1 mo of ageIV 10 to 20 mg/kg/day (5 to 10 mg/lb/day) depending on the severity of the infection; administer in divided doses.
AdultsIM For serious infections, administer 600 mg every 24 h. For more severe infections, 600 mg every 12 h or more often.
Children older than 1 mo of ageIM For serious infections, administer 10 mg/kg (5 mg/lb) every 24 h. For more severe infections, 10 mg/kg (5 mg/lb) every 12 h or more often.
AdultsSubconjunctival 75 mg (0.25 mL)
Severe Renal Function ImpairmentAdults and Children older than 1 mo of age
IV / IM Appropriate dose is 25% to 30% of that recommended for patients with healthy renal function.
General Advice
- IV concentration and rate: 600 to 1,000 mg: Use 100 mL of diluent and administer over a period of not less than 1 h. 2 g: Use 200 mL of diluent and administer over a period of not less than 2 h. 3 g: Use 300 mL of diluent and administer over a period of not less than 3 h. 4 g: Use 400 mL of diluent and administer over a period of not less than 4 h.
Storage/Stability
Store at 68° to 77°F.
Drug Interactions
Aluminum saltsGI absorption of lincomycin may be decreased and delayed.
ErythromycinMay cause antagonism.
Neuromuscular blocking agentsMay enhance the effects of neuromuscular blocking agents.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Cardiopulmonary arrest and hypotension following too rapid IV administration.
Dermatologic
Erythema multiforme; exfoliative and vesiculobullous dermatitis; rash; Stevens-Johnson syndrome; urticaria.
EENT
Tinnitus; vertigo.
GI
Colitis; diarrhea; glossitis; nausea; pruritus ani; pseudomembranous colitis; stomatitis; vomiting.
Genitourinary
Azotemia; oliguria; proteinuria; vaginitis.
Hematologic-Lymphatic
Agranulocytosis; aplastic anemia; leukopenia; neutropenia; pancytopenia; thrombocytopenic purpura.
Hepatic
Abnormal LFT (particularly serum transaminase); jaundice.
Hypersensitivity
Anaphylaxis; angioneurotic edema; serum sickness.
Precautions
WarningsLincomycin can cause Clostridium difficile –associated diarrhea (CDAD), which may range in severity from mild diarrhea to fatal colitis. Hypertoxin-producing strains of C. difficile can be refractory to antimicrobial therapy and may require colectomy. Consider CDAD in all patients presenting with diarrhea following lincomycin use; it may occur later than 2 mo after therapy. Promptly manage cases by administering appropriate fluids, electrolytes, protein supplementation, and antibiotic treatment. |
MonitorMonitor patients, especially elderly patients, for changes in bowel frequency. Perform periodic hepatic and renal function tests and blood cell counts. |
Pregnancy
Category C .
Lactation
Excreted in breast milk.
Children
Safety and efficacy not established in children younger than 1 mo of age.
Elderly
May be more susceptible to changes in bowel frequency.
Renal Function
Serum t ½ may be prolonged in patients with severe renal function impairment. Use with caution.
Hepatic Function
Serum t ½ may be 2-fold longer in patient with abnormal hepatic function. Use with caution.
Special Risk Patients
Use with caution in patients with a history of asthma, significant allergies, or GI disease, particularly colitis
Superinfection
May result in bacterial, fungal, or yeast overgrowth of nonsusceptible organisms.
Anaphylactoid reactions
Serious anaphylactoid reactions requiring immediate emergency treatment may occur.
Benzyl alcohol
Sterile solution contains benzyl alcohol as a preservative, which has been associated with fatal gasping syndrome in premature infants.
Cardiopulmonary reactions
May occur when the drug is administered at greater than the recommended concentration and rate.
Meningitis
Drug levels in the CSF may be inadequate for the treatment of meningitis.
Overdosage
Symptoms
No data.
Patient Information
- Instruct patients to contact health care provider as soon as possible if watery or bloody stools occur.
- Instruct patients not to stop taking this medicine, even if they start to feel better.
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lincomycin Oral, Injection - Includes detailed dosage instructions.
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Conjunctivitis, Bacterial, Bacterial Infection
