Lincomycin - instructions for use, doses, side effects, contraindications

Reversible binding to the ribosome 50S subunit of bacterial cells: disruption of attachment of the amino acid residue of aminoacyl-tRNA to the peptidyl transferase site located on the 50S subunitpeptidyl interaction with its substrate (amino acid), the absence of peptide bond formation, thus, inhibiting protein synthesis.

Pharmacokinetics:

Absorption - 20-30%, decrease when eating. Penetration in cerebrospinal fluid weak. The connection with plasma proteins is 26-86% (an average of 70-75%). Biotransformation in the liver. The half-life - 4-6 h, liver failure - 8-12 hours with renal insufficiency -. 10-20 h elimination kidney (3-70% unchanged - depending upon the mode of administration), intestine (30-40% in unmodified form). It is not removed during hemodialysis.

Indications:

Infectious-inflammatory diseases heavy currents, caused by susceptible microorganisms (mainly staphylococci and streptococci, especially microorganisms resistant to penicillins, as well as allergies to penicillin): lower respiratory tract infections (including aspiration pneumonia, lung abscess, empyema) otitis, bone and joint infections (acute and chronic osteomyelitis, purulent arthritis), purulent skin and soft tissue infections (pyoderma, furunculosis, cellulitis, erysipelas, wound infection).

ICD-10

I.A30-A49.A46 Erys

XII.L00-L08.L02 Abscess of skin, boil and carbuncle

XII.L00-L08.L03 Phlegmon

XII.L00-L08.L08.0 Pyoderma

Contraindications:

Hypersensitivity, pregnancy (except when necessary for "vital" indications), severe hepatic and / or renal failure; breast-feeding, early infancy (up to 1 month).

Carefully:

Fungal diseases of the skin, mucous membrane of the mouth, vagina; myasthenia gravis (for parenteral administration).

Pregnancy and lactation:

Penetrates through the placenta, can accumulate in the liver of the fetus. Complications are not registered. Do not apply!

The FDA category is not defined.

Dosing and Administration:

Admission to adults - 500 mg 3-4 times a day or intramuscularly - 600 mg 1-2 times a day. Intravenously drip 600 mg in 250 ml of isotonic sodium chloride solution or glucose 2-3 times a day.

Children aged 1 month to 14 years inside - 30-60 mg / kg per day; intravenously drip in a dose of 10-20 mg / kg every 8-12 hours.

When topical application is applied a thin layer on the affected areas skin.

Side effects:

Pseudomembranous colitis (severe abdominal pain, diarrhea with a watery or bloody stool, fever) - withdrawal of the drug.

Hypersensitivity (skin rash, itching, polymorphic exudative erythema, including Stevens-Johnson syndrome, anaphylactoid reactions).

Neutropenia (sore throat, fever).

Thrombocytopenic purpura or thrombocytopathy.

Reactions from the gastrointestinal tract (diarrhea, nausea, vomiting, increased activity of aminotransferases).

Fungal lesions (itching of the anus, genitals).

With rapid intravenous injection of high concentrations of lincomycin - lowering blood pressure, dizziness, general weakness, cardiac arrest, apnea.

Contact dermatitis or hypersensitivity.

Action on the central nervous system (dizziness, headache).

Dysfunction of the gastrointestinal tract, hypersensitivity.

Overdose:

Pseudomembranous colitis, hypotension, cardiac arrest.

Treatment: metronidazole or vancomycin intravenously for 10 days.

Interaction:

Adsorbent and antidiarrhoeal agents - decrease of lincomycin absorption, take 2 hours before or 3-4 hours after lincomycin.

Ointment for external use: soaps, disinfectants containing abrasive / medicines, anti-acne preparations,causing skin peeling (resorcinol, salicylate, sulfur), alcohol-containing preparations (lotions), cosmetic products with drying effect, isotretinoin cumulative irritant effect of lincomycin.

Opioid analgesics - increased respiratory depression.

Antidiarrhoeal agents that suppress the intestinal peristalsis - weighting the course of pseudomembranous colitis due to a delay in the elimination of toxins.

Solutions with alkaline medium - incompatible with lincomycin (acidic medium).

Means for inhalation anesthesia (chloroform, cyclopropane, enflurane, halothane, isoflurane, methoxyflurane, trichlorethylene or drugs that block neuromuscular transmission) - strengthening the blockade of neuromuscular transmission, weakness of skeletal muscles, respiratory arrest.

Means for the treatment of myasthenia gravis - reducing effects (dosage correction is probably necessary).

Chloramphenicol (levomycetin) or erythromycin - reduction of the effects of lincomycin due to its displacement from the bonds with the subunit of the 50S ribosome.

Special instructions:

Therapy of diseases caused by group A beta-hemolytic streptococcus should last no less than 10 days to prevent the development of rheumatic fever.Persons sensitized to lincomycin may have sensitization to clindamycin, and vice versa.

Monitoring: colonoscopy, sigmoidoscopy, stool examination (early diagnosis of antibiotic-associated pseudomembranous colitis), aspartate aminotransferase, alanine aminotransferase.

Distinctive characteristics

The antibiotic of the lincosamide group produced Streptomyces lincolnensis or other related actinomycetes.

In the world practice it was previously used for the treatment of infections caused by sensitive microorganisms (streptococci, staphylococci), but was replaced by safer and more effective drugs.

Instructions

Lincomycin (Lincomycinum)