Lincosamides Flashcards
What are the available lincosamides?
- Clindamycin
2. Lincomycin
What is the MOA of lincosamides?
Bacteriostatic
What are the indications for lincosamides?
- Alternative to patients with allergy to penicillin or cephalosporins
- Toxoplasma encephalitis/abscess
- Bacterial vaginosis (clindamycin)
- Anaerobic Infections
What are the precautions to using a lincosamide?
- Serious allergic reaction to clindamycin or lincomycin - contraindicated
Are lincosamides safe in pregnancy and breastfeeding?
Safe to use in pregnancy and breastfeeding (may cause loose bowel actions in the baby)
What are the common adverse reactions to lincosamides?
Diarrhoea Nausea Vomiting Abdominal pain or cramps Rash Itch Contact dermatitis (with topical use)
What are the infrequent adverse reactions to lincosamides?
Clostridium difficile-associated disease
What are the rare adverse effects for lincosamides?
Anaphylaxis Serious skin reations Blood dyscrasias Jaundice Hepatotoxicity (with high doses)
IV: Hypotension (rapid injection), cardiac arrest (rapid injection), thrombophlebitis
IM: pain, induration, sterile abcess
What microbes are lincosamides active against?
- Staphylococci
- Streptococci
- Most anaerobes
- Some protozoa
Which lincosamide is only available as n injection?
Lincomycin is only available as an injection
What are the monitoring requirements for lincosamides?
Monitor complete blood count, hepatic and renal function during prolonged treatment
Is there cross-resistance between lincosamides?
There is complete cross-resistance between clindamycin and lincomycin
Is there cross resistance between lincosmaides and other antimicrobials?
Often there is cross-resistance between lincosamides and macrolides for staphylococci and streptococci
Which lincosamide is preferred?
Clindamycin is generally preferred to lincomycin as it is more potent; some clinicians use higher than the recommended dose of lincomycin for serious infections and at these doses lincomycin has similar efficacy to clindamycin
What is the indications for clindamycin use?
- Alternative to patients with allergy to penicillin or cephalosporins
- Toxoplasma encephalitis/abscess
- Bacterial vaginosis (clindamycin)
- Anaerobic Infections
- Treatment of PCP, with primaquine (second line)
- Malaria (with quinine)
- Acne
What is the usual dose range for clindamycin?
Adult, oral, 150-450mg q6-8hrs
IV, 600-2700mg daily given in 2-4 doses, usually 450-900mg q8hr. Maximum IV 4.8g daily
What is the treatment dose of clindamycin for dental infections?
Oral, 300-459mg q8hr for 5-7 days
What is the treatment dose of clindamycin for PCP infection?
Give with primaquine for 21 days.
Oral, 450 mg every 6–8 hours or 600 mg every 8 hours.
IV, 600 mg every 6 hours or 900 mg every 8 hours.
What is the treatment dose of clindamycin malaria infection?
Give with quinine.
Oral, 450 mg every 8 hours for 7 days.
What is the treatment dose of clindamycin bacterial vaginosis infection?
Oral, 300 mg twice a day for 7 days.
What is the prophylaxis dose of clindamycin for endocarditis prophylaxis (high risk)?
Oral, 600 mg 1–2 hours before dental procedure.
IV, 600 mg within 2 hours before dental procedure.
What is the surgical prophylaxis dose of clindaymin?
IV, 600 mg within 2 hours before incision
What are the counselling points for clindamycin?
Take with a full glass of water. Stop taking this medication and tell your doctor immediately if you develop diarrhoea.
Check with your doctor or pharmacist before taking any antidiarrhoeal medications.
What are the available product strengths of clindamycin?
Capsules 150mg
What are the precautions to lincomycin use?
- Serious allergic reaction to clindamycin or lincomycin - contraindicated
- Renal: Reduce dose if CrCL <10mL/min
- Hepatic: reduce dose in severe impairment
What is the usual dose of lincomycin?
IV, 600 mg – 1 g every 8–12 hours (usually 600 mg every 8 hours). Maximum 8 g daily.
