Lincomycin

Lincomycin is an antibiotic from the group of lincosamides, which is used to treat various infectious diseases caused by microorganisms sensitive to it. Here are the main indications for the use of lincomycin:

1. Respiratory tract infections: The drug may be used to treat bacterial respiratory tract infections such as bronchitis, pneumonia, bronchopneumonia and others.
2. Skin and soft tissue infections: The drug may be used for bacterial infections of the skin and soft tissues such as boils, cellulitis, folliculitis and others.
3. Urinary tract infections: Lincomycin may be effective in treating urinary tract infections, including cystitis, urethritis, and pyelonephritis.
4. Genital infections: The drug may be used to treat bacterial infections of the genitals, such as vaginitis or vulvitis in women and urethritis in men.
5. Bone and joint infections: The drug may be used to treat bacterial infections of bones and joints, such as osteomyelitis and arthritis.

It is important to remember that lincomycin should only be used as prescribed by your doctor and as recommended by your doctor. Improper use of antibiotics can lead to the development of antibiotic resistance and other serious problems. In addition, the drug can cause various side effects and these should be discussed with your doctor before starting treatment.

Indications Lincomycin

1. Respiratory tract infections: Including bronchitis, pneumonia, bronchopneumonia, sinusitis, pharyngitis, laryngitis and other bacterial respiratory tract infections.
2. Skin and soft tissue infections: Generally, lincomycin is used to treat boils, abscesses, cellulitis, wounds, and other skin and soft tissue infections.
3. Urinary tract infections: Including cystitis, urethritis, pyelonephritis and other bacterial infections of the urinary tract.
4. Genital infections: The drug can be used for the treatment of vaginitis, cervicitis, vulvitis in women and urethritis in men.
5. Bone and joint infections: For example, osteomyelitis, arthritis, and other bacterial infections of the bones and joints.
6. Acne: In some cases, lincomycin may be used to treat acne.
7. Prophylaxis: Sometimes the drug may be prescribed to prevent infections before surgery or wounding.

Release form

1. Oral capsules: Most often contain 250 mg or 500 mg of the active substance. Capsules are convenient to take at home when there is no need for immediate action of the antibiotic.
2. Solution forinjection: Used for intramuscular (IM) or intravenous (IV) administration. The solution for injection provides a more rapid therapeutic effect and is used in conditions requiring immediate antibiotic action or when oral administration is not clinically feasible.

Pharmacodynamics

1. Mechanism of Action:

   • Lincomycin suppresses bacterial growth by inhibiting protein synthesis in microorganisms. It binds to the 50S subunit of ribosomes, which prevents the formation of a peptide bond between amino acids and inhibits ribosome progression on mRNA. This leads to impaired protein synthesis, which in turn leads to bacterial death.

2. Scope:

   • The drug is active against many gram-positive and some gram-negative aerobic and anaerobic bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Corynebacterium diphtheriae, Clostridium perfringens and others.

3. Developing Resilience:

   • Like many other antibiotics, prolonged and frequent use of lincomycin can help bacteria develop resistance to it. This can make the medicine less effective in treating infections.

Examples of bacteria that may be sensitive to the drug include:

1. Gram-positive bacteria:

   • Staphylococcus aureus (including methicillin-resistant strains)
   • Streptococcus pneumoniae
   • Streptococcus pyogenes
   • Enterococcus faecalis
   • Clostridium spp.
   • Corynebacterium diphtheriae
   • Listeria monocytogenes
   • and others.

2. Some gram-negative bacteria:

   • Haemophilus influenzae
   • Neisseria gonorrhoeae
   • and others.

Pharmacokinetics

1. Absorption: The drug is usually well absorbed after oral administration. It can be administered either orally or intravenously and its absorption may be improved when taken on an empty stomach.
2. Distribution: Lincomycin is well distributed in tissues and organs of the body, including lungs, kidneys, bones and soft tissues. It can also penetrate the placental barrier and be excreted in breast milk.
3. Metabolism: The drug is almost not metabolized in the body. It retains its activity in unchanged form.
4. Excretion: Lincomycin is excreted mainly through the kidneys in unchanged form. Small amounts may also be excreted through the bile.
5. Half-life: The half-life of the drug is about 3-4 hours in adult patients with normal renal function.

It is important to note that pharmacokinetics of lincomycin may be altered in patients with impaired renal or hepatic function, which requires dose adjustment. It is also worth considering possible interactions with other drugs that may affect its metabolism or excretion from the body.

Dosing and administration

Lincomycin in capsules

• For adults: The standard dose is 500 mg every 6-8 hours. In more severe cases, the dosage may be increased to 500 mg every 4 hours.
• For children over 1 month of age: Dosage is based on the child's weight, usually 10 mg per kilogram of body weight every 6-8 hours.

Capsules should be taken with plenty of water to facilitate swallowing and improve absorption of the drug. It is better to take the drug 1 hour before a meal or 2 hours after a meal, as food may slow down and reduce its absorption.

Lincomycin in the form of solution for injection

• For intramuscular (i.m.) administration: The standard dose for adults is 600 mg every 24 hours. Depending on the severity of the infection, the dose may be increased to 600 mg every 12 hours.
• For intravenous (IV) administration: The drug is usually administered IV slowly for at least 1 minute for every 100 mg of the drug. The standard dose is 600 mg every 8-12 hours.
• For children over 1 month of age: The dose for IM or IV administration is also based on the child's weight, usually 10-20 mg per kilogram of body weight per day, divided into equal doses and administered every 8-12 hours.

General recommendations

• It is necessary to carefully monitor the body's reaction to the treatment and report all unwanted effects to the doctor.
• Do not stop taking the antibiotic prematurely, even if symptoms improve, as this can lead to a recurrence of the infection and the development of bacterial resistance to the drug.
• Lincomycin may interact with other medications, so it is important to tell your doctor about all medications you are taking.

Use Lincomycin during pregnancy

Lincomycin preparations are classified as category D by the FDA (Food and Drug Administration), which means a potential risk to the fetus, especially in the second and third trimesters of pregnancy. Use of the drug may result in effects on developing teeth and bone tissue in the fetus.

Therefore, doctors generally recommend avoiding the use of lincomycin during pregnancy, especially if alternative, safer antibiotics are available.

However, in some cases where the use of the drug is considered necessary to treat a serious bacterial infection in a pregnant woman, the doctor may decide to use it after weighing the potential benefits and risks.

Contraindications

1. Hypersensitivity: Patients with known hypersensitivity to lincomycin or other antibiotics from the lincosamide group (such as clarithromycin or erythromycin) should not use this drug because of the risk of allergic reactions.
2. Asthma: Use of the drug may worsen asthma symptoms in some patients, so it should be used with caution in patients with a history of this condition.
3. Hepatic insufficiency: Lincomycin should be used with caution in patients with severe hepatic dysfunction, as it may increase toxic effects on the liver.
4. Renal insufficiency: Patients with severe renal impairment should use the drug with caution, as the drug dose may require adjustment.
5. Myasthenia gravis: Lincomycin should be used with caution in patients with myasthenia gravis as it may worsen the symptoms of this disease.
6. Pregnancy and breastfeeding: Use of the drug during pregnancy or breastfeeding may require careful weighing of benefits and risks, and the decision should be made by a physician.
7. Children: The safety and efficacy of lincomycin in children under 18 years of age have not been adequately established; therefore, its use in this age group may be limited.

Side effects Lincomycin

1. Dry place: Store the tablets or capsules of the drug in a dry place to avoid moisture, which may affect their stability.
2. Protection from light: Store the drug in a dark place or in a package protected from direct sunlight. Light may cause decomposition of the active ingredients of the medicine.
3. Room Temperature: It is generally recommended to store lincomycin at room temperature, which is usually between 15 and 25 degrees Celsius.
4. Keepout of reach ofchildren: Keep the drug out of reach of children to avoid accidental use.
5. Avoid humidity: It is not recommended to store tablets or capsules of the drug in the bathroom or other places with high humidity.
6. Manufacturer's instructions: Always follow the directions on the package or in the instructions for use provided by the drug manufacturer.

Overdose

1. Toxic Effects:

   • An overdose of lincomycin can cause toxic effects including nausea, vomiting, abdominal pain, and diarrhea.

2. Liver and kidney damage:

   • High doses of the drug may cause severe liver and kidney damage.

3. Gastrointestinal disorders:

   • An overdose of lincomycin can cause serious gastrointestinal disturbances such as intestinal bleeding and ulcers.

4. Allergic Reactions:

   • Some people may have an allergic reaction to the drug, including hives, itching, swelling of the throat, and even anaphylactic shock.

5. Supersensitivity:

   • Some people may have hypersensitivity to lincomycin, which can lead to more serious side effects if overdosed.

Interactions with other drugs

1. Erythromycin, Clarithromycin, Azithromycin and other macrolides: Interactions between lincomycin and macrolides may increase the antibacterial effect and may also increase the risk of side effects such as gastrointestinal disorders and allergic reactions.
2. Clarithromycin and Erythromycin: These macrolide antibiotics may compete with the drug for a binding site to bacterial ribosomes, which may reduce its effectiveness.
3. Cyclosporine: Cyclosporine and lincomycin may interact, increasing renal toxicity.
4. Neomycin and Colistin: These antibiotics can potentiate neuromuscular blockers such as the drug, which may lead to an increased risk of neuromuscular blockades.
5. Parasympathomimetics (e.g. Pilocarpine): Lincomycin may increase the effect of parasympathomimetics, leading to increased stimulation of muscarinic receptors.
6. Warfarin and other anticoagulants: The drug may increase the effect of anticoagulants, leading to an increased risk of bleeding.
7. Ethanol: Ethanol may increase the hepatotoxicity of lincomycin.
8. Drugs metabolized by cytochrome P450 isoenzymes (e.g., cyclosporine, theophylline, terfenadine): The drug may decrease the metabolism of these drugs, resulting in an increase in their blood concentrations.

Storage conditions

1. Dry place: Store the tablets or capsules of the drug in a dry place to avoid moisture, which may affect their stability.
2. Protection from light: Store the drug in a dark place or in a package protected from direct sunlight. Light may cause decomposition of the active ingredients of the medicine.
3. Room Temperature: It is generally recommended to store lincomycin at room temperature, which is usually between 15 and 25 degrees Celsius.
4. Keepout of reach ofchildren: Keep the drug out of reach of children to avoid accidental use.
5. Avoid humidity: It is not recommended to store tablets or capsules of the drug in the bathroom or other places with high humidity.
6. Manufacturer's instructions: Always follow the directions on the package or in the instructions for use provided by the drug manufacturer.