Lincomycin and Clindamycin are collectively known as as Lincosamides 

Linsosamides Clindamycin, Lincomycin +  Nondepolaring-                                          Actions of the NNBs may be enhanced possibly resulting in profound and Neuromucular severe respiratory depression Blockers (NNBs)

Clindamycin-                                                                                                         Parentral/intraperitoneal administration of high doses of certain antibiotics with Pancuronium produce neuromuscular block on its own. If these agents are used preoperatively or in conjunction with pancuronium during surgery, unexpected prolongation of neuromuscular block is a possibility

+ Lincosamides

Erythromycin-                                                                                                           antagonism has occured in vitro between clindamycin and erythromycin

Kailin-Pectin-                                                                                                                          GI absorption is decreased for lincomycin and delayed for clindamycin when they are administered with kaolin-pectin antidiarrheals 

Susceptible strains of Pneumococci and staphlococci. ,used Concomittantly with other antimicrobial agents when indicated.

Lincomycin and Clindamycin are collectively known as as Lincosamides 

GI- nausea, vomiting, diarrhea, pseudomembraneous colitis, Hematologic- neutropenia, leukopenia, agranulocytosis, thrombocytopenic purpura

Hypersensitivity- skin rashes, urticaria, erythema multiforme, some cases resembling Stevens-Johnson syndrome(rare) anaphylaxis Hepatic- jaundice, liver function test abnormalities(serum transminase elevation)

Renal- dysfunction has been characterized by azotemia, oliguria, and proteinuria (rare)

Local- pain following injection, induration and sterile abscess have occurred after IM injection and thrombophlebitis after IV infusion with clindamycin, give deep IM injections and avoid prolonged use of IV catheters. Clindamycin

GI -abdominal pain, esophagitis, anorexia, unpleasant or metallic taste,(following higher doses of IV clindamycin) Hypersensitivity- maculopapular rash, generalized morbilliform-lke rash

Body as a whole- transcient eosinophilia,polyarthritis (rare) Lincomycin GI- glossitis, stomatitis, pruritus ani.

Hematologic- aplastic anemia, pancytopenia (rare) Hypersensitivity- angioneurotic edema, serum sickness

Special senses- tinnitus, vertigo

Body as a whole- vaginitis, exfoliative vesiculobullous dermatitis (rare)

Hypersens,development of pseudomembranous colitis.

Special precautions:

Renal and hepatic disease, pregnancy and lactation.

Monitoring- prolonged therapy-perform liver/kidney functiontests,blood counts IV infusion- Do NOT inject IV undiluted as a bolus, infuse over at least 10 to 60 minutes.

GI diseases- use cautiously in patients with GI disease, particularly colitis

Benzyl alcohol- some products contain benzyl alcohol which has been associated with fatal and - gasping syndrome-in premature infants

Superinfection- use of antibiotics for prolonged periods may result in bacterial or fungal overgrowth of nonsuseptible organisms, particularly yeasts. Such overgrowth may lead to secondary infection. Take appropiate measures if superinfection occurs.

Drug/Food interactions- Food impairs the absorption of linconycin, do not take anything by mouth (except water) for 1 or 2 hours before and after lincomycin.

Clindamycin absorption is not affected by food.

Warnings

Meningitis- clindamycin does not diffuse adequately into CSF, not for meningitis

Hypersensitivity- use with caution in patients with history of asthma or significant allergies. If hypersensitivity occurs,discontunue the drug and institute emergency treatment.

Renal function impairment- cautiously give clindamyc to patients with severe or heptic disease accompanied by severe metabolic aberations.

Monitor serum clindamycin during high dose therapy. Use of lincomycin in preexisting liver disease is not recommended.

Elderly- older patients with associated severe illness may not tolerate diarrhea well. Carefully monitor patients for changes in bowel frequency.

Pregnancy- Safety for use in pregnancy has not been established.

Lactation- Both Clindamycin and Lincomycin appear in breat milk. Breast feeding is probably best discontinued when taking these agents to avoid potential problems to the infant. However,the American Academy of Pediatrics considers clindamycin to be compatible with breast feeding.

Children- Lincomycin is not indicated fr use in the newborn. When clindamycin is administered to newborns and infants monitor organ system functions.

Indications:

Susceptible strains of Pneumococci and staphlococci. ,used Concomittantly with other antimicrobial agents when indicated.

Dosage:

Oral- Take at least 1 or 2 hours before or after eating to ensure optium absorption. Adult- serious infections- 500mg every 8 hours. More serious infections - more than 500mg every 6 hours.. Children more than 1 month of age- Serious infections- 30mg/kg/day(15mg/lb/day) divided into 3 or 4 equal doses. More serious infections- 60mg/kg/day(30mg/lb/day) divided into 3 or 4 equal doses.

Parentral-

IM administration is well tolerated. Adults- serious infections- 600mg every 24 hours. More serious infections- 600 mg every 12 hours or more often. Children more than 1 month of age- serious infection-10mg/kg(5mg/lb) every 24 hours. More severe infections- 10mg/kg(5mg/lb) every 12 hours or more often.

Missed dose-

1. If you miss a dose of this medicine, take it as soon as possible.

2. However, if it is almost time for next dose, skip the missed dose and go back to your regular dosing schedule.

3. Do not double doses.

Diarrhea or Colitis- Drugs causing Adverse Reactions - ( 385 )

1. Lincomycin

2. Clindamycin

3. Broad Spectrum antibiotics

4. Magnesiun in antacids

5. Guanethidine

6. Debrisoquin

7. Methyldopa

8. Reserpine

9. Digitalis

10. Colchicine

11. Purgatives

12. Lactose exceipents

1. May cause diarrhea, notify physician if this occurs

2. Take each dose with a full glass of water.

3. Complete full course of therapy

4. Do not take anything by mouth ( except water ) for 1 or 2 hours before and after lincomycin.

5. Lincomycin may be taken without regards to meals.

Food impairs the absorption of linconycin, do not take anything by mouth (except water) for 1 or 2 hours before and after lincomycin. Clindamycin absorption is not affected by food.

Pregnancy-

Safety for use in pregnancy has not been established. Lactation- Both Clindamycin and Lincomycin appear in breat milk. Breast feeding is probably best discontinued when taking these agents to avoid potential problems to the infant. However,the American Academy of Pediatrics considers clindamycin to be compatible with breast feeding.

Children-

Lincomycin is not indicated fr use in the newborn. When clindamycin is administered to newborns and infants .Monitor organ system functions.